Use of three-dimensional reconstruction of multi-slice spiral CT in pedicle screw fixation in thoracolumbar spine fracture

English Keywords:Thoracolumbar spine fracture  Pedicle screw  Fixation  Spiral CT

English Abstract:

  【Abstract】 Objective：To evaluate the use of three-dimensional reconstruction of multi-slice spiral CT（MSCT） in pedicle screw fixation in thoracolumbar spine fracture.Method：A retrospective analysis was carried out in 78 cases of thoracolumbar fracture undergoing pedicle screw fixation from January 2007 to December 2008.Group A included 38 patients undergoing pedicle screw placement by conventional Weinstein or AO method，while group B included 40 patients undergoing pedicle screw placement by use of three-dimensional reconstruction of MSCT.Postoperative anteroposterior and lateral X rays and CT scans were performed in all patients to evaluate the accuracy of the pedicle screw placement.The accuracy of the pedicle screw was compared in two groups by the method of Lonstein.Result：A total of 436 screws in 78 cases were placed.32 perforations of pedicles were found in 12 patients of group A and 6 perforations of pedicles in 5 patients of group B，with the accuracy rate of screw placement in group A and B of 84.91%（212 screws in 38 patients） and 97.33%（224 screws in 40 patients） respectively，which showed significant difference between two groups（P<0.05）.Conclusion：Compared with conventional methods，screw channel determination by three-dimensional reconstruction of MSCT can improve the accuracy of pedicle screw fixation for thoracolumbar spine fracture.