{Reference Type}: Randomized Controlled Trial
{Title}: [Clinical application of percutaneous pedicle screw placement guided by ultrasound volume navigation combined with X-ray fluoroscopy: a prospective randomized controlled study].
{Author}: Lin X;Shang L;Shen S;Wang Q;Fu X;Zhao G;
{Journal}: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
{Volume}: 37
{Issue}: 10
{Year}: 2023 Oct 15
暂无{DOI}: 10.7507/1002-1892.202306071
{Abstract}: <B>UNASSIGNED: </B>To explore the feasibility and accuracy of ultrasound volume navigation (UVN) combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation through a prospective randomized controlled study.<BR><B>UNASSIGNED: </B>Patients with thoracic and lumbar vertebral fractures scheduled for percutaneous pedicle screw fixation between January 2022 and January 2023 were enrolled. Among them, 60 patients met the selection criteria and were included in the study. There were 28 males and 32 females, with an average age of 49.5 years (range, 29-60 years). The cause of injury included 20 cases of traffic accidents, 21 cases of falls, 17 cases of slips, and 2 cases of heavy object impact. The interval from injury to hospital admission ranged from 1 to 5 days (mean, 1.57 days). The fracture located at T 12 in 15 cases, L 1 in 20 cases, L 2 in 19 cases, and L 3 in 6 cases. The study used each patient as their own control, randomly guiding pedicle screw implantation using UVN combined with X-ray fluoroscopy on one side of the vertebral body and the adjacent segment (trial group), while the other side was implanted under X-ray fluoroscopy (control group). A total of 4 screws and 2 rods were implanted in each patient. The implantation time and fluoroscopy frequency during implantation of each screw, angle deviation and distance deviation between actual and preoperative planned trajectory by imaging examination, and the occurrence of zygapophysial joint invasion were recorded.<BR><B>UNASSIGNED: </B>In terms of screw implantation time, fluoroscopy frequency, angle deviation, distance deviation, and incidence of zygapophysial joint invasion, the trial group showed superior results compared to the control group, and the differences were significant ( P<0.05).<BR><B>UNASSIGNED: </B>UVN combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation can yreduce screw implantation time, adjust dynamically, reduce operational difficulty, and reduce radiation damage.<BR><B>UNASSIGNED: </B>通过前瞻性随机对照研究，探讨超声容积导航（ultrasound volume navigation，UVN）结合X线透视技术引导经皮椎弓根螺钉植入的可行性及准确性。.<BR><B>UNASSIGNED: </B>以2022年1月—2023年1月因胸、腰椎骨折拟行经皮椎弓根螺钉内固定治疗的患者为研究对象，其中60例符合选择标准纳入研究。男28例，女32例；年龄29～60岁，平均49.5岁。致伤原因：交通事故伤20例，摔伤21例，跌倒伤17例，重物砸伤2例。受伤至入院时间1～5 d，平均1.57 d。骨折部位：T 1215例，L 120例，L 2 19例，L 3 6例。 研究采用患者自身左右侧对照，随机在骨折椎体上、下节段一侧椎弓根采用UVN结合X线透视技术引导植钉（试验组），另一侧于X线透视下植钉（对照组）；每例患者植入4枚螺钉、2根钉棒。记录每枚螺钉的植钉时间、植钉过程中透视次数，影像学检查实际螺钉与术前规划钉道角度差值、距离偏差值以及螺钉侵犯关节突关节数量。.<BR><B>UNASSIGNED: </B>试验组植钉时间、透视次数、钉道角度差值、钉道距离偏差值、关节突关节侵犯率方面均优于对照组，差异均有统计学意义（ P<0.05）。.<BR><B>UNASSIGNED: </B>UVN结合X线透视技术引导下行经皮椎弓根螺钉植入能减少植钉时间，可实时动态调整，降低操作难度，减少辐射伤害。.