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自由手与导航辅助的C2踏板螺丝固定的比较:回顾性准确性和安全性分析
Ilker Kiraz1, Burak Eral2, Buse Sarigul3
1Department of Neurosurgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
Journal of craniovertebral junction & spine
|December 11, 2025
概括
自由手和导航辅助的C2踏板螺丝固定技术都显示出高精度和低并发症率. 外科医生的经验和患者因素应指导自由手和导航辅助方法之间的选择用于宫稳定.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- C2跨脚螺丝固定是上脊柱稳定的一个关键技术.
- C2脊椎的解剖学复杂性为螺丝放置带来了重大挑战.
- 确保准确的螺丝放置对于生物力学稳定性和患者安全至关重要.
研究的目的:
- 为了比较使用自由手与导航辅助技术的C2踏板螺丝放置的准确性,错位率和并发症.
- 通过验证的放射学分类系统 (格茨贝恩-罗宾斯分类和螺丝区分类) 评估螺丝精度.
- 在统计学上比较这两种技术之间的人口,临床和手术数据.
主要方法:
- 在2010年至2019年期间,对100名接受C2脚螺丝固定治疗的患者进行了回顾性比较研究.
- 分析了197个螺丝:45个使用自由手 (FH) 技术,152个使用导航辅助 (NA) 方法.
- 使用Gertzbein-Robbins分类 (GRC) 和螺丝区分类 (SZC) 评估了螺丝精度.
主要成果:
- 在这两组中,螺丝精度都很高,SZC显示区域2放置在86.7% (FH) 和87.5% (NA).
- 错位率 (GRC等级B-D) 是相似的:FH螺丝的13.3%,NA螺丝的12.5%.
- 没有观察到神经血管并发症或与螺丝相关的修订;然而,NA组有5次修订的伤口脱光.
结论:
- 自由手和导航辅助的C2踏板螺丝放置技术都提供了卓越的准确性和较低的并发症率.
- 虽然导航可以提高经验丰富的外科医生的准确性,但自由手技术仍然是一个可行的和安全的替代方案.
- 在选择技术时,应考虑外科医生的经验,患者的解剖学和可用的机构资源.
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