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手柄式脊柱内固定导引器的研制及初步应用
史建刚,贾连顺*,袁文*,赵辉,陈德玉,王波,陈雄生,贾宁阳,宋滇文,史国栋,麻彬,吴建锋
0
(第二军医大学长征医院骨科, 上海 200003
*通信作者)
摘要:
目的:设计一种简单便携的脊柱手术实时监测工具并初步评价其应用效果,减少战地脊柱脊髓损伤救治的医源性损伤。方法:自行设计并制备手柄式脊柱内固定导引器。离体脊柱标本随机分为对照组(n=10)和实验组(n=10),对照组采用常规方法进行椎弓根开道,实验组采用自行设计的手柄式脊柱内固定导引器进行椎弓根开道。记录两组各标本的操作时间,术后将标本沿椎弓根平面水平剖开,比较两组标本的开道位置及进针深度。结果:对照组和实验组处理单个椎体时间分别为(0.5±0.2)min、(0.6±0.1)min,两组无统计学差异;对照组穿刺道边缘距离椎弓根壁平均距离(mm)明显短于实验组(1.1±0.3vs1.8±0.2,P=0.037)。结论:手柄式脊柱内固定导引器携带方便,操作简单,体外初步应用效果尚可,能够为早期手术提供可靠参考。
关键词:  脊柱损伤  脊髓损伤  骨折内固定术  关键技术  导航
DOI:10.3724/SP.J.1008.2009.00558
投稿时间:2008-12-30修订日期:2009-03-13
基金项目:国家自然科学基金(30872613).
A portable spinal fixation guiding device: design, preparation and preliminary application
SHIJian-gang,JIALian-shun*,YUAN Wen*,ZHAO Hui,CHEN De-yu,WANGBo,CHEN Xiong-sheng,JIA Ning-yang,SONGDian-wen,SHIGuo-dong,MABin,WUJian-feng
(Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author)
Abstract:
Objective: To design a portable real-time monitoring tool for spine surgery and to preliminarily evaluate its application, so as to reduce the iatrogenic injury during the treatment of battle field spinal cord injury. Methods: A portable spine guiding device for spinal fixation was designed and prepared. The spinal specimens were randomly divided into control group (n=10) and experimental group (n=10). In the control group the way was cleared for the pedicle according to the doctor's experience; in the experimental group the way was cleared using our self-designed guiding device. The operation time was recorded in the two groups. After manipulation the specimens were opened along the pedicle level; the location and the depth of the needle were compared. Results: The manipulation time of a single vertebral body was (0.5±0.2) min in the control group and (0.6±0.1) min in the experimental group (P>0.05). The edge of the puncture to the pedicle wall in the control group was significantly shorter than that in the experimental group([1.1±0.3] vs [1.8±0.2]mm,P=0.037).Conclusion:The designed portable guiding device for spinal fixation is easy to carry, simple to operate; and initial in vitro application is satisfactory and can provide reliable reference for early operation.
Key words:  spinal injuries  spinal cord injuries  internal fracture fixation  key technique  navigation