Objective To evaluate our self-designed guide used clinically in percutaneous placement of lumbosacral pedicle screws in surgery of lumbar vertebral fractures.Methods From May 2012 to March 2015,143 patients with lumbar vertebral fracture were treated with reduction and fixation using percutaneous lumbosacral pedicle screws in our department.Percutaneous placement of lumbosacral pedicle screws was assisted by our self-designed guide in 69 of them(guide group) but not in the other 74 cases (manual group).The 2 groups were compatible in preoperative general data (P ＞ 0.05).The 2 groups were compared in terms of localization time for a single screw,puncture accuracy,times of intraoperative fluoroscopy,operation time,intraoperative blood loss,and hospital stay.Results The guide group had significantly better localization time for a single screw,puncture accuracy,times of fluoroscopy and operation time than the manual group (P ＜ 0.05),but the 2 groups showed no significant differences in intraoperative blood loss and hospital stay (P ＞ 0.05).The guide group obtained an average follow-up of 12.9 months (from 12 to 16 months) while the manual group obtained an average follow-up of 13.2 months (from 12 to 18 months).All fractures healed primarily,without complications like injuries to nerve root or dural sac.Conclusion Our self-designed guide is recommendable because it can obviously improve accuracy of placement of lumbosacral pedicle screws,shorten operation time,and decrease times of intraoperative fluoroscopy.

Objective:To investigate the needle placement accuracy assisted by our self-designed channel screw guide system for pelvic fractures.Methods:Sixty pelvic models (provided by Shandong Weigao Group) were randomized into 2 groups ( n=30). In the experimental group, 2.0 mm Kirkler needles were implanted into the sacroiliac channel using our self-developed channel needle guide system in corresponding simulated surgical procedures; in the control group, the guide needles for sacroiliac screws were implanted manually under the guidance of C-arm fluoroscopy. The needle positions were assessed by gross observation and the offset distances measured on the X-ray films of pelvic entrance and exit views between the guide needle at the midline of the sacrum and the center point of bone channel. The offset distance, operation time, fluoroscopy frequency, and needle adjustment frequency were compared between the 2 groups of guide needles. Results:Guide needles were successfully implanted in all the pelvic models in the experimental group, with no penetration of guide needles outside the model. In the control group, 3 guide needles penetrated outside the model channel. The X-ray measurements showed that the offset distance of the needle in the experimental group was (2.23±0.82) mm, significantly smaller than that in the control group [(4.46±2.28) mm] ( P<0.05). In the experimental group, the fluoroscopy frequency [(12.0±0.3) times] and the needle adjustment frequency [(8.0±0.3) times] were significantly less than those in the control group [(26.0±0.4) times and (24.0±0.8) times] ( P<0.05). The operation time was (0.52±0.25) hours in the experimental group, significantly shorter than that in the control group [(1.26±0.36) hours] ( P<0.05). With a 2 mm diameter as an acceptable range, the accuracy was as high as 95.5%. Conclusion:Compared with manual placement of guide needles, our self-designed pelvic fracture channel screw guide system can lead to more accurate needle placement, reduced fluoroscopy frequency, fewer guide needle adjustments, and shortened operation time.