导航引导椎弓根钉内固定系统治疗胸腰段椎体爆裂骨折

目的评价计算机导航引导椎弓根内固定系统治疗胸腰椎爆裂性骨折的安全性与准确性。方法回顾性分析2009年1月至2011年1月汕头大学医学院第二附属医院收治的56例胸腰椎爆裂性骨折患者的临床资料，其中导航组26例、常规手术组30例。对比分析两组的置钉安全性、准确性，手术时间，术中出血量及手术疗效等指标。结果56例患者共置钉268枚，准确置钉248枚（92．5％）。导航组和常规手术组置钉成功率分别为93．6％和91．7％、手术时间分别为（2．4±0．4）h和（2．2±0．7）h，两组比较，差异无统计学意义（P〉0．05）。导航组和常规手术组术中出血量分别为（184±49）mL和（276±81）mL，两组比较，差异有统计学意义（P〈0．05）。过伸过屈动力摄片显示固定段无异常活动，未发现椎弓根钉松动、断裂。结论计算机导航辅助椎弓根内固定术治疗胸腰椎爆裂性骨折安全性和准确性较好，可减少术中出血量，疗效满意。

Treatment of pedicle screw internal fixation with computer assisted surgical navigation system for thoracolumbar burst fractures

Objective To evaluate the satety ana accuracy ot pealcle screw internal nxanon tecnmque Ior the treatment of thoracolumbar burst fractures using computer assisted surgical navigation（CASN） system. Methods Clinical data of 56 patients with thoracolumbar burse fractures underwent pediele screw fixation from January 2009 to January 2011 in the Second Affiliated Hospital of Shantou University Medical College were reviewed retrospectively. There were 26 cases in CASN group and 30 cases in conventional group which performed conventional operation. The safety and accuracy of pedicle screw insertion, operation time, estimate blood loss and clinical results between two groups were analyzed and compared. Results Out of 268 screws 248 were correctly inserted into the pedicles （92.5%）. The accuracy of CASN group was 93.6% while in conventional group was 91.7%, there was no statistical difference between two groups （P 〉0.05）. The operation time in CASN group was （2.4 ± 0.4） h while that in conventional group was （2.2 ± 0.7） h, there was no significant difference between two groups （P 〉0.05）. The estimate blood loss in CASN group was （184 ± 49） mL while that in conventional group was （276 ＋ 81） mL, the difference between two groups had statistical significance （P 〈0.05）. Dynamic flexion-extension X-ray radiographs showed that no abnormal activity in fixation segments, and no loosening or breakage of pedicle screws had been found. Coneluslons Pedicle screw internal fixation with CASN system can improve the safety and accuracy of pedicle screw insertion and reduce the estimate blood loss, and obtain good therapeutic effects for patients with thoracolumbar burst fractures.