CAJ | 학술논문

背景：三维可视化软件在临床治疗中的应用价值已经得到了普遍认可。医生可以应用术前可视化软件在复杂脊柱骨折模型上进行安全的演示以此获得经验，同时可以根据患者个性化的三维模型制定出个性化的螺钉置入方案。 　　目的：观察置钉前应用可视化技术指导椎弓根螺钉内固定治疗短节段腰椎骨折脱位的临床效果。 　　方法：纳入32例腰椎椎体骨折脱位患者，置钉前通过Mimics软件观察椎弓根完整性并测量置钉相关参数，通过置钉前重建三维影像向患者讲解置钉方式及相关并发症，共置入182枚椎弓根螺钉。评估患者知情同意满意度、手术时间、置钉后CT平扫螺钉的位置情况。测量置钉前、置钉后2周及置钉后8个月伤椎椎体前缘高度的比值和Cobb’s角，了解置钉后骨折复位情况以及随访期间有无内固定失败和复位丢失情况。 　　结果与结论：患者知情同意非常满意者占100%，手术时间平均185 min，置钉后CT平扫173枚螺钉(95.1%)完全位于椎弓根内，经随访7-22个月，患者骨折均达到临床骨性愈合。置钉后2周伤椎椎体前缘高度、Cobb’s角均较置钉前有显著改善(P<0.05)，置钉后8个月伤椎椎体前缘高度和Cobb’s角与置钉后2周差异无显著性意义(P>0.05)。提示通过伤椎椎弓根钉道可视化技术能够有效指导治疗单一节段腰段骨折。这种方法可使医生进行术前计划，提高患者的病情知情同意满意率，缩短手术时间，提高置钉后螺钉位置满意度。
배경：삼유가시화연건재림상치료중적응용개치이경득도료보편인가。의생가이응용술전가시화연건재복잡척주골절모형상진행안전적연시이차획득경험，동시가이근거환자개성화적삼유모형제정출개성화적라정치입방안。 　　목적：관찰치정전응용가시화기술지도추궁근라정내고정치료단절단요추골절탈위적림상효과。 　　방법：납입32례요추추체골절탈위환자，치정전통과Mimics연건관찰추궁근완정성병측량치정상관삼수，통과치정전중건삼유영상향환자강해치정방식급상관병발증，공치입182매추궁근라정。평고환자지정동의만의도、수술시간、치정후CT평소라정적위치정황。측량치정전、치정후2주급치정후8개월상추추체전연고도적비치화Cobb’s각，료해치정후골절복위정황이급수방기간유무내고정실패화복위주실정황。 　　결과여결론：환자지정동의비상만의자점100%，수술시간평균185 min，치정후CT평소173매라정(95.1%)완전위우추궁근내，경수방7-22개월，환자골절균체도림상골성유합。치정후2주상추추체전연고도、Cobb’s각균교치정전유현저개선(P<0.05)，치정후8개월상추추체전연고도화Cobb’s각여치정후2주차이무현저성의의(P>0.05)。제시통과상추추궁근정도가시화기술능구유효지도치료단일절단요단골절。저충방법가사의생진행술전계화，제고환자적병정지정동의만의솔，축단수술시간，제고치정후라정위치만의도。
BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients. OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization. METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation. RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P<0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months fol ow-up (P>0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.