ABSTRACT
[ Abstract ] Objective To explore the effect of 3D print-based navigation module assisted placement of thoracolumbar pedicle screws. Methods From January 2019 to May 2021, we received 70 thoracic and lumbar fracture patients, divided into 3D technical group and conventional method group according to the surgical method, with 35 patients in each group. In the 3D technology group, pedicle screws were placed under the sight of the navigation module, while in the conventional group, pedicle screws were placed under the conventional C-arm fluoroscopy. The amount of intraoperative bleeding and time of C arm were counted in each patient. According to the different number of pedicle screw implantation in each patient, the average amount of blood loss, time and C-arm fluoroscopy times of each screw implantation were compared between the two groups. Ideal screw angles were designed for patients in both groups before surgery. Compared with the preoperative design, the difference between preoperative and postoperative screw angle and head angle was calculated and set as the deviation value. Two sets of data were compared. Visual analogue score(VAS), Japanese Orthopaedic Association (JOA) score, Oswestry disability index(ODI), vertebral height recovery ratio and Cobb’ s angle were compared between the two groups. Results The amount of blood loss, required time and exposure times of C-arm in 3D screw implantation group were significantly lower than those in conventional screw implantation group(P0. 05); In terms of Cobb’s angle and vertebral height recovery ratio, the 3D technique group was better than the conventional method group (P<0. 05). Conclusion The 3D printed navigation module can assist the precise placement of thoracolumbar pedicle screws, shorten the operation time, reduce intraoperative bleeding and c-arm exposure times, facilitate the recovery of the injured vertebral height, improve the efficacy.
ABSTRACT
Objective To research the morphological classification of inferior angle of scapula based on CT 3D reconstruction and its clinical significance. Methods A total of 290 scapular bones data were collected from People's Hospital of Lu Xian County and measured based on CT 3D reconstruction. The scapular bones images were reconstructed by CT 3D technique. Reference points; g was the inferior scapular angle, n was the inferior glenotubular nodule, m was the intersection of the scapular ganglion and the medial edge of the scapula, k was the upper scapular angle, r was the notch of the scapular glenoid, h was the intersection of point g to mr. The parameters of inferior angles of 290 scapular bones, including the thickness of point g (the thickest part of inferior angle of the scapula), the length of the line gn, line gm, and line gh, and the angle of ∠ ngm, ∠ gmk (the projection of the scapular coronal plane), and ∠ gmk' (the projection of the scapular sagittal plane) were observed and measured by CT 3D technique. Results Under the CT three-dimensional reconstruction, the inferior angle of scapula was classified into three types; accessory angle-type ( 175, 60. 34%), U-type ( 81, 27. 93%) and V-type (34, 11. 73%). In addition, there was a significant difference between the auxiliary angle type and the V type on the thickest part of the g point and gn (P<0.05); U-type and V-type with paragonai gm-significant difference (P<0.05); There was a significant difference between the auxiliary angle type and the U shape on gh (P<0.05); there was a significant difference between the auxiliary angle type and the U shape on ∠ gmk' (P<0.05). There was a significant difference in the inferior angle of the bilateral scapula on mngm (P<0.05). Conclusion Based on the result of CT three-dimensional reconstruction, the inferior angle of scapulae have three anatomical types, with the accessory angle-type as the main type, and the morphology and classification of it are of certain clinical implication.