使用计算机导航技术辅助脊柱骨折和不稳定的固定手术

目的 讨论应用红外线主动诱导计算机辅助三维导航系统进行脊柱外科复杂结构的手术以期提高手术安全性。方法 2002年12月～2004年7月，我们共施行红外线主动诱导计算机辅助三维导航下脊柱外科手术90例，其中各种骨折病例38例，施行椎弓根固定236枚。由于腰椎椎弓根较粗，术中透视比较容易，除非畸形明显，除正侧位X线片判断位置困难的病例外，均使用二维导航技术，其余使用三维导航技术。结果 本组236枚螺钉术后均进行了CT检查，位置不满意4枚(1．7％)，位置误差率0．23～0．56mm(导航仪自动计算)；而过去应用单纯G型或C型臂透视下先后进行了272枚颈椎椎弓根螺钉固定，其中有29枚(10．7％)位置不满意，相比之下，前者结果满意。结论 计算机导航使得手术部位的确定变得简单、手术时间缩短、手术的安全性明显提高。

Fixation assisted by computer navigation for spinal fracture and instability

Objective To discuss application of initiative infrared ray computer assisted 3D navigation system in spinal complex operation to improve surgical safety. Methods From December 2002 to July 2004, we performed 90 cases of spinal operation assisted by computer 3D navigation system. There were 38 cases of spinal fractures, and 236 cases of pedicle fixation. In lumbar spine surgery, fluoroscopy was commonly used, because the pedicle of lumbar spine was thick enough. 3D computer navigation was used in the other cases. Results 4 screws (1.7%) were not in good position, and the position error rate was 0.23 to 0.56 mm (automatically calculated by the computer). But we had once performed 272 cases of fixation with cervical pedicle screws just assisted by G arm or C arm fluoroscopy, 29 (10.7%) of which were not in good position. Conclusion In comparison, computer navigation assisted operation can make pedicle screw positioning more correct.