CT scanning applied in the preoperative planning of lumbar spine surgeries / 中国组织工程研究

ABSTRACT

BACKGROUND: Pedicle screws are widely used in spinal internal fixation, while complications related to screw mistaken placement can be found occasionally. Conventional imaging examination cannot provide the accurate situation of the nail, and the nail path can be directly revealed on CT.OBJECTIVE: To discuss the application of CT scanning in the preoperative planning of lumbar spine surgery using digital technology.METHODS: 136 patients were enrolled, and digital technology was used to determine the best nailing track on planar CT images. Then the length of the pedicle screws, width of the pedicle, angle between pedicle screws and standard sagittal plane, and angle between pedicle screw and spinous process as well as sagittal plane were measured. The difference in measured values on each side was compared. Also, the difference in angle between pedicle screw and sagittal plane and spinous process was compared.RESULTS AND CONCLUSION: (1) There was no significant difference in the length of pedicle screw in both sides (P > 0.05). (2) There was significant difference in the width of pedicle screw at L1 and L4 of two sides (P 0.05). (4) The angle between pedicle screw and spinous process at each level bilaterally did not differ significantly (P > 0.05). (5) To conclude, pedicle CT scanning can accurately reflect patients' pedicle anatomic situation, which can help surgeons to design an appropriate scheme. Moreover, the anatomical variations of lumbar spine are remarkable, so pedicle screw insertion should be planned individuality.