光辅助X射线体表定位在骨科植入物内固定中的应用

背景：以往骨科内固定常使用C臂机进行体表定位,但固定中的反复透视会加大对人体的损伤及延长固定时间。目的：探寻一种简便实用、更有利于骨科内固定的光辅助X射线体表定位技术。方法：使用自制的简易装置将雷达状的红色激光投射在体表来辅助C臂机进行体表定位。使用SD大鼠和新西兰大白兔设计动物实验,模拟软组织内异物定位、骨折髓内钉远端锁钉置入、脊柱椎弓根螺钉进针点定位3种骨科内固定方法。分别使用传统C臂机和光辅助X射线体表定位技术各进行 30次定位。分析2种方法对操作的影响,并分析深度和活体因素对光辅助X射线体表定位技术的影响。结果与结论：与传统C臂机定位相比,光辅助X射线体表定位技术在实验过程中能够更快的进行体表定位(P < 0.05),但定位的深度和活体因素会影响光辅助X射线体表定位技术的准确度(P < 0.05)。说明光辅助X射线体表定位技术具有简便、快速、动态化的优点,可方便骨科内固定的进行,但在固定过程中需考虑各种因素对定位准确性的影响,减小或消除这些影响因素将更好的发挥光辅助X射线体表定位技术的优势。

Body surface localization using laser auxiliary X-ray in orthopaedic implant internal fixation

BACKGROUND:C-arm X-ray machine is often used in orthopedic surgery to perform the body surface localization. But the repeatedly perspective during the fixation surgery will increase the damage to the human body and prolong operation time.OBJECTIVE:To explore a kind of simple practical technology of body surface localization by laser auxiliary X-ray used in the orthopedic surgery.METHODS:The radar-shaped red laser was projected in the body surface by self-made simple device to assistant the C-arm machine to perform body surface localization. Sprague Dawley rats and New Zealand white rabbits were used to design animal experiment, three kinds of orthopedic surgeries were simulated. Traditional C- arm machine and the technology of body surface localization by laser auxiliary X-ray was used separately to get position of foreign body in soft tissue, place the distal cross-bolting of fracture intramedullary nail, and place the pedicle screw in spinal surgery. There were 30 cases in every test. The influence of two methods to the operation was analyzed, and the influence of depth and living body to the technology of body surface localization by laser auxiliary X-ray was analyzed.RESULTS AND CONCLUSION:Compared with the traditional C-arm machine, the technology of body surface localization by laser auxiliary X-ray could obtain the body surface localization more faster (P < 0.05). But the depth and living body may influence the accuracy of technology of body surface localization by laser auxiliary X-ray (P < 0.05). It suggested that the technology of body surface localization by laser auxiliary X-ray has the advantages of convenient, fast and dynamic which could be greatly convenient for orthopaedic surgery. But various kinds of influential factors should be reduced or eliminated in order to better the advantages of the technology in the operation process.