术中O-Arm 3D 成像和导航下引导颈椎前路椎弓根钉置入

    摘要：［目的］ 探讨术中O-Arm 3D 成像和导航下引导颈椎前路椎弓根钉置入的技术方法。［方法］ 采用标准的Smith-Robinson 颈椎前路入路。椎间盘切除和安置Cage 后，将导航参考架安放在锁骨上。在术中O-Arm 3D 成像和导航引导下置入颈椎前路椎弓根钉。术中和术后CT 评价前路椎弓根钉置入的准确性。［结果］ CT 显示前路椎弓根钉准确地置入椎弓根皮质内，无椎动脉和神经损伤。［结论］ 术中O-Arm 3D 成像和导航引导下颈椎前路椎弓根钉置入是一种安全有效的方法。
    关键词：颈椎前路椎弓根螺钉， 术中导航， 安全
    中图分类号：R687 文献标志码：A 文章编号：1005-8478 （2017） 16-1501-05
    Cervical anterior pedicle screw insertion using stealth navigation and 3D image-guided (O-Arm) technology //ZHANG Zheng- feng. Department of Orthopedics, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037,China
    Abstract: ［Objective］ To report a new surgical technique of cervical anterior pedicle screw (CAPS) fixation using stealth navigation and 3D image-guided (O-Arm) technique. ［Method］ After a standard Smith-Robinson anterior cervical approach was made, discectomy and insertion of a peek cage were conducted. As the reference array was placed on the clavicle, CAPS were inserted using O-Arm and stealth navigation. The accuracy of pedicle screw placement was checked intraoperatively and postoperatively by CT scans respectively. ［Result］ CT images showed accurate placement of pedicle screws within the pedicle cortex. No vascular or neurologic complication due to aberrant screw placement occurred. ［Conclusion］ Placement of CAPS using O-Arm/stealth navigation is a safe and effective method for anterior stabilization in the subaxial cervical spine. 
    Key words: cervical anterior pedicle screw， intraoperative navigation， safety