用三角形棒的Bedrock技术用于脊骨固定和关节融合:有没有学习曲线?
Cale J Hendricks1, Jason J Haselhuhn2, Paul Brian O Soriano2
1Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA. hend0643@umn.edu.
概括
圣关节 (SI) 融合的Bedrock技术显示,三角形杆 (TTRs) 的植入错位率为4.7%,并且随着时间的推移,这种率会下降. 这种技术改善了患者的治疗结果,满足了疼痛和功能的临床重要差异.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
背景情况:
- 在Bedrock技术中,在长脊髓与骨盆的融合过程中,通过在S2AI螺丝附近放置的三角形杆 (TTRs) 将关节 (SI) 融合.
- 最初的经验显示,7.1%的植入物错位率需要手术内纠正.
研究的目的:
- 用Bedrock技术在更大的队列中评估植入物错位率.
- 确定与TTR安置相关的潜在学习曲线.
- 报告减少植入物错位的策略.
主要方法:
- 在2019年5月至2021年5月期间,对43名用Bedrock技术 (TTRs和CT导航) 进行SI关节融合的患者进行了回顾性审查.
- 对TTR和S2AI螺丝的手术内错位的操作报告的分析.
- 人口,手术和患者报告结果测量 (PROM) 数据的相关性.
主要成果:
- 在86个植入的TTR和S2AI螺丝中,4.7%的TTR需要重新定位,1.2%被更换;没有S2AI螺丝被错位.
- 对TTR的错位率从前21个案例中的7.1%下降到后22个案例中的4.5%,表明潜在的学习曲线.
- 患者在ODI,VAS背部和PROMIS-10得分方面表现出显著的一年改善,满足ODI和VAS背部的MCID.
结论:
- 在S2AI螺丝上方的后部TTR放置,由于盆腔解剖学和植入物设计存在技术挑战,导致中间/头脑部位置不当.
- 观察到的错位率的下降表明了学习曲线,S2AI螺丝的错位率为0%,TTRs为5.8%.
- 在眼中更低地修改植入物放置是最大限度地减少错位风险的策略.
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