Study On The Accuracy Of Computer Aided Simulated Set-nail Technique In The Application Of Atlas Lateral Mass Screw

Objective To explore the feasibility of computer aided analog staple technique in the localization of atlas lateral mass screw.Methods A total of 51 patients with atlantoaxial instability were treated retrospectively from January 2014 to January 2016 in the Department of Orthopedic Surgery,Henan Provincial People’s Hospital,including 28 males and 23 females,Aged 31-54 years,mean age 42.7 years.A total of 27 patients were randomly divided into two groups:experimental group,7 cases of old odontoid fractures,12 cases of congenital dentate dysplasia,12 cases of fresh odontoid fractures(Anderson IIC type)in 8 cases;not using BOHOLO surgical simulator preoperative planning for a total of 24 cases,defined as the control group,of which 6 cases of old odontoid fracture,congenital dentate dysplasia in 10 cases,Fresh dentate fracture(Anderson IIC type)8 cases.The experimental group of preoperative CT data into BOHOLO software designed atlas lateral mass of the best nail,the definition of parameters(into the spine to the outer edge of the pedicle that is the distance between the pedicle edge L1,to the sagittal sagittal distance L2(P <0.05).The number of nail length D,the horizontal angle of the crucified channel,and the sagittal angle SSA were measured.The actual postoperative parameters of the experimental group were measured by BOHOLO software.Compared with the preoperative planning parameters,the operation time(min)Intraoperative blood loss(ml),the two groups of patients after surgery CT,by BOHOLO multi-planar reorganization imaging in the CT axial and coronal observation of the two groups of screw position,in the axial division of the lateral positioning of the reliable area: Articular surface in the side of the projection area,the region of the screw fixation and the strength of the most reliable,reliable area outside the regional nail strength is not reliable and damage the spinal cord or vertebral artery risk.The efficacy was evaluated according to the postoperative complications,preoperative and last follow-up JOA score,VAS score,and fusion rate.Results All patients had no vertebral artery and nerve injury,and were followed up for 7to 13 months,mean 9 months,and 6 months after operation.Bone fusion was obtained and no screw was loosened,Displacement,fracture of the situation occurred.There was no significant difference in baseline data and medical records between the two groups.The experimental group consisted of 54 pieces of atlas lateral mass screws,which were located in the reliable area,accounting for 100%.The optimal cruise parameters L1(5.00 ± 0.92 mm on the left,5.19 ± 0.83 mm on the right),L2(left(Left side 20.27±1.62 mm,right side 20.26±1.53mm),TSA(left side 12.11±1.40 °,right side 11.93±1.47°),SSA(right side 18.96±1.09mm)Left side of the line 19.82±1.33°,the right 19.56±1.31°),the actual cruise parameters L1 ’(left4.74 ± 0.71 mm,right 5.11 ± 0.97mm),L2’(left 18.96 ± 1.16 mm,right 19.04(Left side 20.48±1.55 mm,right side 20.48±1.81 mm),TSA ’(left side 12.19±1.57 °,right side 12.22±1.48 °),SSA’(left side 19.74±1.29°,The right side of 19.41± 1.22°),the difference was not statistically significant(P> 0.05).(P <0.05).The operation time of the two groups was(107.22 ± 12.96 min,116.88 ± 16.73min),and the number of screws in the control group was 87.5%(403.70±101.61 ml,484.58±138.00ml),the difference was statistically significant(P <0.05).The preoperative JOA scores were(6.89±1.65,7.33±1.58),VAS score(13.7±2.54,12.58±2.62),the VAS scores were(1.70 ± 0.61,1.54 ± 0.66),and the difference was significant(P<0.05),and the scores were(3.67 ± 0.73,3.46 ± 0.59)(P <0.05),but there was no significant difference between the two groups(P> 0.05).Conclusion Computer-aided analog nail technique can assist in the accurate operation of the nail,and help to improve the accuracy of nail,reduce intraoperative bleeding,shorten the operation time.