颈椎椎弓根形态个体化术前应用CT测量评价的临床意义

目的为有效施行颈椎椎弓根固定术,临床探讨术前采用CT测量的颈椎椎弓根置钉准确度以及置钉可行性。方法选取我院2014年2月-2015年7月期间96例行颈椎椎弓根固定患者,分为手测组、CT组,按入院时间进行分配,每组48例。CT组术前采用CT测量椎弓根高度、宽度确定置钉点,手测组采用手工测量椎弓根确定置钉点,观察置钉成功率、置钉准确度,记录椎弓根测量情况以及置钉时间、出血量。结果 CT组每钉置钉时间、出血量分别为(3.78±2.45)min、(307.42±179.47)ml明显少于手测组的(4.65±2.34)min以及(367.42±165.49)ml(P0.05);CT组与手测组在椎弓根高度、椎弓根宽度的C3-C6椎弓根参数测量值比较差别无意义(P0.05);CT组置钉准确度高达95.8%,出现全穿破率仅为4.2%,手测组为85.4%,且全穿破率高达14.6%,CT组较手测组置钉准确度高(P0.05)。结论临床采用CT测量所得椎弓根参数准确度高、临床置钉准确度高,且出血量少、置钉耗时少,可为临床个体化置钉提供较为准确的数据。

The Clinical Significance of CT Measurement and Evaluation of the Preoperative Application of Cervical Pedicle of Vertebral Arch

Objective To explore the effectiveness of cervical pedicle screw fixation, and to explore the accuracy and feasibility of CT measurement of cervical pedicle screw placement.Methods 96 patients with cervical pedicle screw fixation in our hospital from 2015.7 to 2014.2 were divided into hand test group and CT group, according to the time of admission, each group had 48 cases. CT group preoperatively by CT measurement of pedicle width and height determine the position of screw, hand were measured by manual measurement pedicle to determine the position of screw, observation of screw placement success rate, screw placement accuracy, record of pedicle and pedicle screw fixation time, amount of bleeding.Results CT group each screw placement time, amount of bleeding, respectively (3.78±2.45) min, (30.742±179.47) ml significantly less than in test group (4.65±2.34) min and (367.42±165.49) ml rose ml (P<0.05). CT group and the hand were measured in the C3 pedicle height, pedicle width - C6 pedicle parameter measurement value difference (P>0.05). CT group nailing high accuracy of 95.8%, the perforation rate was only 4.2%, hand were measured was 85.4%, and the perforation rate up to 14.6%, CT group than that of manual test set screw placement accuracy (P<0.05). Conclusion The clinical application of CT measurement has high accuracy, high accuracy of clinical placement, less bleeding and less time, so it can provide more accurate data for clinical individual screw placement.