[1]宋旭东,刘毅,罗波,等.3D-Slicer联合sina软件辅助椎弓根置钉在椎管内肿瘤手术中的应用[J].中国临床神经外科杂志,2022,27(05):341-344.[doi:10.13798/j.issn.1009-153X.2022.05.002]
　SONG Xu-dong,LIU Yi,LUO Bo,et al.Application of 3D-Slicer combined with sina software assisted pedicle screw placement to surgery for intraspinal tumors[J].,2022,27(05):341-344.[doi:10.13798/j.issn.1009-153X.2022.05.002]
点击复制

3D-Slicer联合sina软件辅助椎弓根置钉在椎管内肿瘤手术中的应用()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年05期
页码:
341-344
栏目:
论著
出版日期:
2022-05-31

文章信息/Info

Title:
Application of 3D-Slicer combined with sina software assisted pedicle screw placement to surgery for intraspinal tumors
文章编号:
1009-153X(2022)05-0341-04
作者:
宋旭东; 刘毅; 罗波; 王潇娅
637000四川，南充市中心医院神经外科（宋旭东、刘毅、罗波、王潇娅）
Author(s):
SONG Xu-dong;  LIU Yi;  LUO Bo;  WANG Xiao-ya
Department of Neurosurgery, Nanchong Central Hospital, Nanchong 637000, China
关键词:
椎管内肿瘤; 显微手术; 椎弓根置钉; 3D-Slicer软件; sina软件
Keywords:
Intraspinal tumor;  Microsurgery;  Pediclescrewplacement;  3D Slicer software;  Sina software
分类号:
R739.42;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.05.002
文献标志码:
A
摘要:
目的 探讨3D-Slicer联合sina软件辅助椎弓根置钉技术在椎管内肿瘤手术中的应用效果。方法 回顾性分析2018年1月至2021年1月手术治疗的46例椎管内肿瘤的临床资料。术中应用3D-Slicer联合sina软件辅助定位置钉26例（观察组），徒手定位置钉20例（对照组）。术后行C臂、CT扫描，按照Gertzbein-Robbins方法评估置钉的准确性。结果 观察组术中射线量、单钉置入时间、术中出血量、术后术区引流量、术后住院时间均明显低于对照组（P<0.05）。观察组置钉穿破皮质骨发生率（16.38%）、不良置钉率（5.17%）、术中调整置钉率（18.10%）明显低于对照组（分别31.11%、13.33%、37.78%；P<0.05）。两组血管神经损伤及术后1年内钉棒相关并发症发生率均无统计学差异（P>0.05）。结论 与徒手定位置钉相比，3D-Slicer联合sina软件辅助椎弓根置钉，明显提高置钉的准确性，并具减少手术相关的副损伤，缩短住院时间。
Abstract:
Objective To investigate the value of 3D slicer combined with sina software assisted pedicle screw placement in the surgery for the patients with intraspinal tumor. Methods A retrospective analysis was performed on the clinical data of 46 patients with intraspinal tumor who underwent microsurgery from January 2018 to January 2021. The 3D-Slicer combined with sina software assisted pedicle screw placement was used in 26 patients (observation group), and conventional freehand pedicle screw placement was used in 20 patients (control group). All the patients underwent C-arm and CT scan after pedicle screw placement, and the accuracy of pedicle screw placement was evaluated by Gertzbein-Robbins method. Results The amount of intraoperative radiation, the finish time of single screw, the mount of intraoperative blood loss, the postoperative drainage volume and postoperative hospital stay in the observation group were significantly less than those in the control group (P<0.05). The rates of broken cortical bone, bad screw placement and intraoperative adjustment of screw placement in the observation group (16.38%, 5.17% and 18.10%, respectively) were significantly lower than those (31.11%, 13.33% and 37.78%, respectively) in the control group (P<0.05). There were no significant differences in the rates of vascular nerve injury and pedicle screw placement related complications within 1 year after surgery between both the groups (P>0.05). Conclusions Compared with conventional freehand pedicle screw placement, 3D-Slicer combined with sina software assisted pedicle screw placement significantly improves the accuracy of screw placement, reduces surgery-related side injuries, and shortens hospital stay.

参考文献/References:

[1] Samartzis D, Gillis CC, Shih P, et al. Intramedullary spinal cordtumors: partⅡ--management options and outcomes [J]. Global Spine J, 2016, 6(2): 176-185.
[2] Song Z, Zhang Z, Ye Y, et al. Efficacy analysis of two surgi- cal treatments for thoracicand lumbar intraspinal tumours [J]. BMC Surg, 2019, 19(1): 131.
[3] Nicoletti G, Furnari M, Giuffrida M, et al. A new tool to improve pedicle screw placement accuracy in navigated spine surgery: amono centric study [J]. J Neurosurg Sci, 2021, 65(3): 348-353.
[4] Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo [J]. Spine (PhilaPa1976), 1990, 15(1): 11-14.
[5] Fachrisal, Setiawan E, Alhuraiby SS. Functional outcome in intradural extramedullary tumor patients: case series [J]. Ann Med Surg (Lond), 2020, 54: 71-73.
[6] Fichtner J, Hofmann N, Rienmüller A, et al. Revision rate of misplaced pedicle screws of the thoracolumbar spine- comparison of three-dimensional fluoroscopy navigation with freehand placement: a systematic analysisand review of the literature [J]. World Neurosurg, 2018, 109: e24-e32.
[7] Laudato PA, Pierzchala K, Schizas C. Pedicle screw inser- tion accuracy usingo-arm, robotic guidance, or freehand technique: a comparative study [J]. Spine (PhilaPa1976), 2018, 43(6): E373-E378.
[8] Hagan MJ, Syed S, Leary OP, et al. Pedicle screw placement using intraoperative computed tomography and computer- aided spinal navigation improves screw accuracy and avoids postoperative revisions: single-center analysis of 1400 pedicle screws [J]. World Neurosurg, 2022, 160: e169- e179.
[9] Kanawati A, Rodrigues Fernandes RJ, Gee A, et al. The development of novel2-in-1 patient-specific, 3d-printed laminectomy guides with integrated pedicle screw drill guides [J]. World Neurosurg, 2021, 149: e821-e827.
[10] 欧阳鹏荣，贺西京，王　栋，等. 3D打印导航模板在寰枢 椎椎弓根螺钉置钉中的应[J]. 中华创伤骨科杂志，2020， 22（10）：862-866.
[11] 彭逸龙，伍　益，陈少霭，等. 3D-slicer软件+手机sina软 件在高血压性脑出血穿刺引流术中的应用[J]. 中国临床 神经外科杂志，2018，23（6）：427-429.

相似文献/References:

[1]林国中　王振宇　马长城　赵　薇.神经电生理监测下显微手术切除脊髓髓内肿瘤[J].中国临床神经外科杂志,2015,(11):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
　LIN Guo-zhong,WANG Zhen-yu,MA Chang-cheng,et al.Clinical value of intraoperative electrophysiological monitoring to microsurgery for intramedullary spinal tumors[J].,2015,(05):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
[2]谢京城　王振宇　陈晓东.骶管终丝脊膜囊肿合并脊髓拴系综合征的诊断和治疗[J].中国临床神经外科杂志,2015,(11):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
　XIE Jing-cheng,WANG Zhen-yu,CHEN Xiao-dong.Diagnosis and surgical treatment of sacral spinal meningeal cysts of fila terminale complicated with tethered spinal cord syndrome[J].,2015,(05):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
[3]于　涛　黄正通　王振宇.椎管内脊膜囊肿的临床特征和治疗方法[J].中国临床神经外科杂志,2015,(11):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
　YU Tao,HUANG Zheng-tong,WANG Zhen-yu.Clinical features and treatment of intraspinal arachnoid cysts[J].,2015,(05):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
[4]谢宝树　王　宇　贾　锋　张　林　殷玉华.神经电生理监测下显微手术治疗成人脊髓栓系综合征[J].中国临床神经外科杂志,2015,(11):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
　XIE Bao-shu,WANG Yu,JIA Feng,et al.Intraoperative electrophysiological monitoring-guided microsurgery on tethered spinal cord syndrome in adults[J].,2015,(05):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
[5]张治元　王汉东　成惠林　赵　鑫　林毅兴　朱　林.神经电生理监测下椎管内肿瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):668.[doi:10.13798/j.issn.1009-153X.2015.11.009]
　ZHANG Zhi-yuan,WANG Han-dong,CHENG Hui-lin,et al.Microsurgery for intraspinal tumors under electrophy- siological monitoring[J].,2015,(05):668.[doi:10.13798/j.issn.1009-153X.2015.11.009]
[6]陈晓东　于　涛　王振宇.脊髓髓内神经鞘瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
　CHEN Xiao-dong,YU Tao,WANG Zhen-yu.Diagnosis and treatment of intramedullary spinal schwannomas[J].,2015,(05):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
[7]马　磊　张海红　张　威　衡立君　孙树凯　贾　栋.眶上锁孔入路手术切除前颅底脑膜瘤的临床效果[J].中国临床神经外科杂志,2015,(11):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
　MA Lei,ZHANG Hai-hong,ZHANG Wei,et al.Microsurgery through supraorbital keyhole approach for anterior cranial fossa meningiomas[J].,2015,(05):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
[8]李春坡　郑　军　李海元　边　涛　韩安国.侧脑室三角区小型脑膜瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):694.[doi:10.13798/j.issn.1009-153X.2015.11.018]
[9]张兆斯　但　炜　王　刚　周　超　孙　超　谢延风　石全红　詹　彦.咪达唑仑和丙泊酚诱导麻醉对继发性癫痫术中皮层脑电图的影响[J].中国临床神经外科杂志,2016,(05):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
　ZHANG Zhao-si,DAN Wei,WANG Gang,et al.Effects of midazolam or propofol used for induction of anesthesia on intraoperative ECoG in patients with secondary epilepsy[J].,2016,(05):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
[10]赵　平　王雄伟　汪　雷　马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
　ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[11]赵东升　王正君　孙刚锋　费　舟　姬西团　李　娟　万晓强.椎管内畸胎瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
　ZHAO Dong-sheng,WANG Zheng-jun,SUN Gang-feng,et al.Dignosis and treatment of intraspainal teratomas[J].,2015,(05):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
[12]田学丰,冯春国,王先祥,等.脊柱内固定技术在切除多节段椎管内肿瘤中的应用（附12例报道）[J].中国临床神经外科杂志,2016,(11):673.[doi:10.13798/j.issn.1009-153X.2016.11.007]
　TIAN Xue-feng,FENG Chun-guo,WANG Xian-xiang,et al.Application of intraspinal internal fixation to microneurosurgery for multilevel spinal tumors (report of 12 cases)[J].,2016,(05):673.[doi:10.13798/j.issn.1009-153X.2016.11.007]
[13]赵焱,程立冬,徐志强,等.巨大型椎管内肿瘤的显微手术治疗[J].中国临床神经外科杂志,2017,(07):483.[doi:10.13798/j.issn.1009-153X.2017.07.012]
　ZHAO Yan,CHENG Li-dong,XU Zhi-qiang,et al.Microsurgery for giant intraspinal tumors (report of 22 cases)[J].,2017,(05):483.[doi:10.13798/j.issn.1009-153X.2017.07.012]
[14]谢　涛　刘　羽　毛　峰　叶　飞.椎管内血管外皮细胞瘤1例[J].中国临床神经外科杂志,2017,(11):799.[doi:10.13798/j.issn.1009-153X.2017.11.025]
[15]刘亚军　王金龙　郭运发　罗　坤.高颈段椎管内肿瘤的显微手术治疗[J].中国临床神经外科杂志,2017,(12):804.[doi:10.13798/j.issn.1009-153X.2017.12.002]
　LIU Ya-jun,WANG Jin-long,GUO Yun-fa,et al.Microneurosurgery for high cervical intraspinal tumors (report of 50 cases)[J].,2017,(05):804.[doi:10.13798/j.issn.1009-153X.2017.12.002]
[16]李　宁　张　帆　尚亚军　王　波　杨智勇　宋晓斌.椎管内畸胎瘤并骶管囊肿致脊髓栓系1例[J].中国临床神经外科杂志,2018,(11):766.[doi:10.13798/j.issn.1009-153X.2017.11.024]
[17]王　佳　史铁钧　王培新　崔绍杰　谭　荣　黑　博　赵全军.经前外侧腹膜后入路手术切除腰椎管巨大 哑铃型肿瘤1例并文献复习[J].中国临床神经外科杂志,2019,(01):52.[doi:10.13798/j.issn.1009-153X.2019.01.017]
[18]缪逸涛　杨　军　陈　庚　洪新雨.肝癌椎管内硬脊膜外转移1例[J].中国临床神经外科杂志,2019,(01):62.[doi:10.13798/j.issn.1009-153X.2019.01.020]
[19]张圣坤 综述,初　明 审校.椎管内肿瘤术中椎管重建方式的选择[J].中国临床神经外科杂志,2019,(04):248.[doi:10.13798/j.issn.1009-153X.2019.04.021]
[20]丁崇学　潘红利　范雁东　李彦东　王金龙　罗　坤.半椎板入路显微手术切除椎管内髓外硬膜下肿瘤的效果分[J].中国临床神经外科杂志,2019,(10):598.[doi:10.13798/j.issn.1009-153X.2019.10.007]
　DING Chong-xue,PAN Hong-li,FAN Yan-dong,et al.Microsurgery via hemilaminectomy for extramedullary and subdural tumors (report of 38 cases)[J].,2019,(05):598.[doi:10.13798/j.issn.1009-153X.2019.10.007]

备注/Memo

备注/Memo:
基金项目：四川省卫生计生委科技项目（18PJ430）
更新日期/Last Update: 2022-06-30