[Percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation].
Zhonghua Wai Ke Za Zhi
; 53(10): 752-6, 2015 Oct 01.
Article
em Zh
| MEDLINE
| ID: mdl-26654307
ABSTRACT
OBJECTIVE:
To retrospectively assess the feasibility and safety of percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation.METHODS:
Thirty patients admitted from April 2012 to May 2014 in Beijing Jishuitan Hospital with cervical fracture underwent pedicle screw fixation using intraoperative three-dimensional fluoroscopy-based navigation, with 8 patients using minimally invasive technique (CAOS-MIS group), and the other 22 patients using conventional open approach (CAOS-open group). Operative time, blood loss and postoperative neurovascular complications were recorded. Screw positions were studied by postoperative CT scan. All patients were followed up for at least 6 months. Neck visual analogue score (VAS) and American Spinal Injury Association (ASIA) classification were evaluated preoperatively and at 6-month follow-up. Independent-sample t test and Chi-Square test were used for statistical analysis.RESULTS:
Operation time was (139 ± 18) minutes and blood loss was (73 ± 40) ml in CAOS-MIS group and correspondingly (154 ± 42) minutes and (296 ± 171) ml in CAOS-open group. The blood loss in CAOS-MIS group was significantly lower than that in CAOS-open group (t = 5.695, P < 0.01). No screw-related injury to nerve or vertebral artery was observed. Thirty-four screws were placed in CAOS-MIS group with 28 screws (82.4%) classified as Grade I, meanwhile in CAOS-open group 108 screws were placed with 96 screws (88.9%) classified as Grade I. There was no statistical difference between the two groups (χ² = 0.998, P > 0.01). VAS score showed no statistical difference preoperatively (t = 0.334, P > 0.01), however statistical difference existed at 6 months follow-up (t = 4.111, P < 0.01) with (0.4 ± 0.5) in CAOS-MIS group and (1.5 ± 0.7) in CAOS-open group. There were 1 patient from class B to improve to D, 1 case from D to E in CAOS-MIS group, and 1 patient from class A to improve to B, 1 case from B to D, 2 cases from C to D, 3 cases from D to E in CAOS-open group 6 months after surgery. Cervical X-ray demonstrated fractures healed well in all cases at 6 months follow-up.CONCLUSION:
It is feasible and safe for percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation, which can also decreases the incidence of postoperative neck pain.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fluoroscopia
/
Fraturas da Coluna Vertebral
/
Procedimentos Cirúrgicos Minimamente Invasivos
/
Procedimentos Ortopédicos
/
Parafusos Pediculares
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
Zh
Revista:
Zhonghua Wai Ke Za Zhi
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
China