Application Study Of 3D O-Arm Navigation In Percutaneous Vertebroplasty

Object: To explore the application effect of 3D O-arm navigation in percutaneous vertebroplasty.Methods:A total of 152 patients who underwent unilateral percutaneous vertebroplasty due to osteoporotic vertebral compression fractures in the Department of Orthopaedic Spine and Arthrology,Guigang People’s Hospital from September 2017 to September 2019.Among them,there were 79 cases in the operation group(group A)assisted by three-dimensional navigation of the O-arm(using a skin fixation reference frame),37 cases of single-vertebral surgery,42 cases of double-vertebral surgery,and 121 vertebral bodies in total.There were 73 cases in the lower surgery group(group B),34 cases in single vertebral surgery,and 39 cases in double vertebral surgery,with a total of 112 vertebral bodies.The success rate of one puncture,the average puncture time of the vertebral body,the average operative time of the vertebrae,the average cumulative radiation dose,the leakage of bone cement and the probability of bilateral distribution of bone cement were observed in the two surgical groups,and the changes of the VSA score before and after the operation were compared.Results:A total of 152 patients in the O-arm 3D navigation group(group A)using the skin-fixed reference frame and the O-arm 2D fluoroscopy group(group B)successfully completed the operation.The average vertebral puncture time in group A was 3.85 ± 0.69 min,and that in group B was 9.59 ± 2.21 min,which was significantly different(P <0.05).The average operation time of single vertebral body in group A was 38.33±2.99 min.The average time of double vertebral body operation was 43.70±3.76 min.Group B was44.25±4.70 min,56.79±5.41 min.The operation time in group A was shorter than that in group B,the difference was statistically significant(P<0.05);The success rate of one puncture in group A was 95.87%.The bone cement leakage rate was7.44%.The bilateral distribution probability was 93.39%.And The group B puncture success rate was 73.21%.The bone cement leakage rate was 17.86%.The bilateral distribution probability was 80.36%.The puncture success rate in group A was significantly higher than that in group B,the bone cement leakage rate in group A was lower than that in group B,and the probability of bilateral distribution in group A was significantly higher than that in group B,with statistically significant differences(P <0.05);The average cumulative radiation doses of group A in single-vertebral surgery and double-vertebral surgery were23.87±1.53 mGy,27.07±2.20 mGy,and those in group B were 31.42±3.96 mGy,38.07±3.92 mGy,respectively.Group B was low,and the difference was statistically significant(P<0.05);the VSA scores of group A and group B after operation were significantly lower than before surgery,the difference was statistically significant(P<0.05),but there was a difference between the two groups no significant(P> 0.05).Conclusions:O-arm 3D navigation percutaneous vertebroplasty has the advantages of more accuracy and safety:(1)intraoperative navigation can quickly establish a precise working channel,reduce radiation exposure,and(2)reduce the risk of puncture complications,which is beneficial for beginners to operate,at the same time increase the scope of surgical indications,(3)skin fixation reference frame to reduce patient trauma,while meeting PVP navigation accuracy requirements.