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山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (12): 103-.

• 临床医学 • 上一篇    下一篇

计算机导航辅助下经关节突寰枢关节螺钉治疗齿状突骨折的临床研究

左灿辉,王鲁博,许世宏,董金磊,周东生   

  1. 山东大学附属省立医院创伤骨科,济南 250021
  • 收稿日期:2012-04-05 出版日期:2012-12-10 发布日期:2012-12-25
  • 通讯作者: 王鲁博(1963- ),男,主任医师,硕士研究生导师,主要从事创伤骨科方面研究。E-mail:wlbbs2006@126.com
  • 作者简介:左灿辉(1986 - ),男,硕士研究生,主要从事创伤骨科方面研究。 E-mail: striving2010@qq.com
  • 基金资助:

    山东省医药卫生科技发展计划(2009年第HZ062号)

Clinical research of atlantoaxial transarticular screw fixation for odontoid
fractures with computer navigation assisted system

ZUO Can-hui, WANG Lu-bo, XU Shi-hong, DONG Jin-lei, ZHOU Dong-sheng   

  1. Department of Traumatic Orthopedics,  Provincial Hospital Affiliated to Shandong University,  Jinan 250021,  China
  • Received:2012-04-05 Online:2012-12-10 Published:2012-12-25

摘要:

目的   通过比较计算机导航辅助下寰枢关节螺钉置钉方法(导航组)与传统C臂透视指导下寰枢关节螺钉置钉方法(传统组)的临床疗效,评估计算机导航辅助技术在经关节突寰枢关节螺钉治疗齿状突骨折中的临床应用价值。方法   对28例经关节突寰枢关节螺钉后路寰枢融合治疗齿状突骨折患者进行回顾性分析,其中导航组13例,传统组15例,比较两组患者手术时间、透视时间、出血量及术后并发症等情况,术后影像学检查评估两组患者螺钉植入的准确性。结果   28例患者共放置寰枢关节螺钉55枚。平均手术时间导航组154.9min,传统组182.2min,两组差异有统计学意义(P<0.01),平均透视时间导航组(41.3s)显著少于传统组(64.3s)(P<0.01)。术后影像学检查显示导航组螺钉位置均满意,传统组中6枚螺钉位置不满意。结论   计算机导航辅助下置入寰枢关节螺钉可以提高手术的安全性和准确性,减少患者和术者射线暴露,缩短手术时间,是治疗齿状突骨折的有效方法。

关键词: 寰枢关节;螺钉固定;齿状突;骨折;计算机导航

Abstract:

Objective   To assess the clinical value of atlantoaxial transarticular screw fixation for odontoid fractures with computer navigation assisted system through comparing the clinical effects of atlantoaxial transarticular screw fixation by computer navigation assisted system (navigation group) with those of atlantoaxial transarticular screw fixation by C-arm fluoroscopy(historic control group). Methods   We retrospectively reviewed twentiy-eight patients diagnosed with odontoid fractures who underwent posterior approach atlantoaxial fusion by transarticular screw fixation. The navigation group included 13 patients and the other 15 patients were in the historic control group. Operative time,  fluoroscopy time,  blood loss and postoperative complications were compared between the two groups. We evaluated the screw accuracy through postoperative radiology examination. Results   Totally 55 atlantoaxial transarticular screws were placed in the twentiy-eight patients. The mean operative time was 154.9 min in the navigation group compared with 182.2 min in the historic control group.There was statistical difference betwe-n the two groups(P<0.01).The mean fluoroscopy time in the navigation group was 41.3s  compared to 64.3s in the historic control group (P<0.01). Postoperative radiographs showed all the screws were placed satisfactorily in the navigation group. The position of six screws in the historic control group was demonstrated suboptimal. Conclusion   The computer navigation assisted system enhanced safety and accuracy of atlantoaxial transarticular screw fixation,  decreased patients and surgeons’ radiation exposure and reduced operation time. This technology is an effective method for the treatment of odontoid fractures.

Key words: Atlantoaxial articulation; Screw fixation;Odontoid process;Fractures;Computer navigation

中图分类号: 

  • R683.2
[1] 信维伟,程光齐,朱颖华,李展春. 经皮椎体成形术治疗骨质疏松性骨折的应用体会[J]. 山东大学学报(医学版), 2009, 47(11): 135-137.
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