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Is bony attachment necessary for dynamic reference frame in navigation-assisted minimally invasive lumbar spine fusion surgery?
Computer Assisted Surgery ( IF 2.1 ) Pub Date : 2019-09-03 , DOI: 10.1080/24699322.2018.1542028
Hsi-Hsien Lin,Yueh-Hsiu Lu,Po-Hsin Chou,Ming-Chau Chang,Shih-Tien Wang,Chien-Lin Liu

This study aimed to compare the accuracy of navigation-assisted percutaneous pedicle screw insertions between traditional posterior superior iliac spine (PSIS) fixed and cutaneously fixed dynamic reference frame (DRF) in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). This is a prospective randomized clinical study. Between May 2016 and Nov 2017, 100 patients who underwent MIS TLIF were randomly divided into bone fixed group (with PSIS fixed DRF) and skin fixed group (with cutaneously fixed DRF). The pedicel screws were inserted under navigational guidance using computed tomography (CT) data acquired intraoperatively with a Ziehm 3-dimensional fluoroscopy-based navigation system. Screw positions were immediately checked by a final intraoperative scan. The accuracy of screw placement was evaluated by a sophisticated computed tomography protocol. Both groups had similar patient demographics. Totally Five-hundred Twelve pedicle screws were placed in the lumbar spine. There were 2 moderate (2–4 mm) pedicle perforations in each group. The accuracy showed no significant difference between bone fixed and skin fixed DRF. There were no significant procedure-related complications. The skin fixed DRF provides similar accuracy in pedicle screw insertions with bone fixed DRF using intraoperative 3D image guided navigation in MIS TLIF. Skin fixed DRF not only serves as an alternative method but also saves a separate incision wound for bony attachment.



中文翻译:

在导航辅助的微创腰椎融合手术中,动态参照系是否需要骨附件?

这项研究旨在比较经椎间孔腰椎椎体间融合术(MIS TLIF)的微创手术中传统后上固定(PSIS)固定和皮肤固定动态参考框架(DRF)之间导航辅助经皮椎弓根螺钉插入的准确性。这是一项前瞻性随机临床研究。在2016年5月至2017年11月之间,将接受MIS TLIF的100例患者随机分为骨固定组(PSIS固定DRF)和皮肤固定组(皮肤固定DRF)。使用基于Ziehm 3维荧光透视的导航系统在术中获取的计算机断层扫描(CT)数据,在导航指导下插入花梗螺钉。通过最终的术中扫描立即检查螺钉位置。通过精密的计算机断层扫描方案评估螺钉放置的准确性。两组患者的人口统计学特征相似。将总共​​十二个椎弓根螺钉放置在腰椎中。每组有2个中度(2-4 mm)椎弓根穿孔。准确度表明,骨固定DRF和皮肤固定DRF之间无显着差异。没有明显的手术相关并发症。使用MIS TLIF中的术中3D图像导航,皮肤固定DRF在椎弓根螺钉插入中的准确性与骨固定DRF相似。皮肤固定的DRF不仅可以作为替代方法,而且还可以保存单独的切口伤口以进行骨附着。每组有2个中度(2-4 mm)椎弓根穿孔。准确度表明,骨固定DRF和皮肤固定DRF之间无显着差异。没有明显的手术相关并发症。使用MIS TLIF中的术中3D图像导航,皮肤固定DRF在椎弓根螺钉插入中的准确性与骨固定DRF相似。皮肤固定的DRF不仅可以作为替代方法,而且还可以保存单独的切口伤口以进行骨附着。每组有2个中度(2-4 mm)椎弓根穿孔。准确度表明,骨固定DRF和皮肤固定DRF之间无显着差异。没有明显的手术相关并发症。使用MIS TLIF中的术中3D图像导航,皮肤固定DRF在椎弓根螺钉插入中的准确性与骨固定DRF相似。皮肤固定的DRF不仅可以作为替代方法,而且还可以保存单独的切口伤口以进行骨附着。

更新日期:2019-09-03
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