Comparison of ultrasound volume navigation and O-arm navigation in percutaneous pedicle screw fixation for thoracolumbar vertebral fractures
10.3760/cma.j.cn115530-20240425-00184
- VernacularTitle:超声容积导航与O型臂导航引导经皮椎弓根螺钉内固定治疗胸腰椎骨折的效果比较
- Author:
Gang ZHAO
1
;
Xuxin LIN
;
Suhong SHEN
;
Qing CHANG
;
Lijie SHANG
;
Zhuo FU
;
Xiaoyan FU
;
Hao FU
;
Yifan WANG
;
Lufan ZHOU
Author Information
1. 河南省洛阳正骨医院（河南省骨科医院）脊柱微创一科，洛阳 471000
- Publication Type:Journal Article
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Fractures, bone;
Ultrasound volume navigation;
O-arm navigation;
Pedicle screws
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(12):1069-1075
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of ultrasound volume navigation (UVN) and that of O-arm navigation in the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation.Methods:A retrospective study was conducted to analyze the clinical data of 29 patients with thoracolumbar vertebral fracture who had been treated with percutaneous pedicle screw fixation at Department Ⅰ of Minimally Invasive Spinal Surgery, Luoyang Orthopedic Hospital from January 2022 to June 2023. The patients were assigned into 2 groups according to different navigation methods. In group UVN of 17 cases, there were 14 males and 3 females with a mean age of 50.0 (44.0, 53.5) years, and the pedicle screw fixation was guided by UVN; in group O-arm of 12 cases, there were 10 males and 2 females with an age of (40.6±11.1) years, and the pedicle screw fixation was guided by O-arm navigation. The 2 groups were compared in terms of insertion time per screw, total dose of intraoperative radiation, radiation dose per screw, accuracy of screw placement, rate of facet joint violation, and visual analogue scale (VAS) pain scores for lumbar pain at postoperative 1, 3, and 6 months.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). There was no statistically significant difference in the insertion time per screw between group UVN and group O-arm [(13.2±1.3) min versus (14.1±1.3) min] ( P>0.05). The total dose of intraoperative radiation and radiation dose per screw in group UVN [(1.80±0.54) mSv and (0.41±0.10) mSv] were significantly lower than those in group O-arm [(3.52±0.33) mSv and (0.85±0.11) mSv] ( P<0.05). The accuracy of screw placement and rate of facet joint violation in group UVN [94.7% (71/75) and 17.6% (3/17)] were not significantly different from those in group O-arm [92.2% (47/51) and 8.3% (1/12)]] ( P>0.05). The VAS score at postoperative 1 month in group UVN [4.0 (3.5, 5.0) points] was significantly lower than that in group O-arm [5.0 (5.0, 6.0) points] ( P<0.05). There were no statistically significant differences between the 2 groups in the VAS pain scores at postoperative 3 and 6 months ( P>0.05). Conclusions:In the treatment of thoracolumbar vertebral fractures with percutaneous pedicle screw fixation, screw placement guided by UVN is as time-saving, intuitive, and accurate as that guided by O-arm navigation. However, UVN is better than O-arm navigation in radiation avoidance and pain relief.
