Tory Burch Outlet Abstract

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With modern technology, various accidents, traumatic injuries such as energy increasing violence, especially in spine fractures and dislocations,[link widoczny dla zalogowanych], often caused by spinal cord injury, paralysis. Open reduction and internal fixation return to normal physiological structure as soon as possible to the recovery. Conventional surgery in spine surgery, only the back exposed, not detailed understanding of the shape and position of the spine and spinal anatomy of the front structure, in the surgical fixation process can not be put in the best position, likely to cause internal fixation piercing, fixation failure, severe cases can cause or aggravate spinal cord injury. According to the literature, pedicle screw malposition rate of 5.2% to 28.1% [2 ~ 4], and more up to 40% [5]. Repeated pinning and fixation failure can, causing the plant after loosening. Traditional method requires repeated intraoperative orientation film or fluoroscopy, radiation volume, operation time, and for the single-plane location, it is difficult to achieve three-dimensional position, and because of repeated C-arm X-ray machine out of the surgical field into the probability of infection. The emergence and application of navigation systems to improve the quality of spinal surgery has far-reaching significance. Currently, CT, MRI, PET, and navigation have been used in clinical DSA. However, orthopedic surgery is unique, because no fixed external reference and a number of uncertainties between the spinal joints and different types of fractures and dislocations, not as intracranial surgery, the preoperative use of CT, MRI image acquisition positioning for the surgery, and surgery for CT, MRI examination due to equipment and cost factors can not be achieved at present, can not be real-time monitoring [6]. Therefore, real-time navigation with its simple, real-time image acquisition spinal surgery positioning become a better choice. Real-time navigation during surgery in the perspective image and Computer -assisted surgical navigation software combine to provide a real-time, multi-level image, while the location of the surgical instruments in real-time intraoperative image update the display, may aid the physician scheduled surgery program, to understand the relative relationship between instruments and anatomical structures, implant surgery to determine the location, angle, length and diameter, and the implementation of the monitoring operation to improve the safety and success rate.
Key words real-time navigation of pedicle screw implants
Thoracic pedicle screw system is the most common posterior surgical fixation system. The accuracy of pedicle screw placement is fixed the system to maximize the efficiency of the key. Undergraduate introduction of GE, C-arm X-ray machine navigation systems, observation and analysis of real-time navigation of pedicle screw placement in the thoracic spine surgery application value.
1.1 study
Real-time navigation monitor thoracic and lumbar pedicle screw surgery value

Abstract real-time navigation of thoracic and lumbar pedicle screw placement in the application of the value of surgery. [Method] hospital in March 2003 ~ March 2006 thoracolumbar fixation in 56 cases, under the guidance of the navigation of pedicle screw placement surgery. [Results] All safe completion of surgery, no screw-related complications. Confirmed by X-ray film after guided navigation into the screw part, entry angle and depth into the nail accurately. [Conclusion] The navigation-guided surgery for pedicle screw placement can be shortened operative time, intraoperative film or perspective to reduce radiation, increase the accuracy into the nail.
2003 年 3 months to March 2006 in the course of treatment of thoracolumbar spine fracture and dislocation or slippage such as pedicle screw fixation of the patient, a total of 56 cases, total of 246 pedicle . Of which 22 cases of fracture and dislocation of the patients, average 32.4 years old (17 to 41 years); 32 cases of spondylolisthesis patients, an average of 55.6 years (39 to 69 years); metastatic carcinoma in 2 cases. 34 of them under the thoracic pedicle; sacral pedicle 18; rest lumbar pedicle.
1 Materials and Methods
1.2 surgical methods

Preoperative preparation of patients with normal posterior spinal surgery, the surgical skin preparation, combined blood,[link widoczny dla zalogowanych], indwelling catheterization. Intubation satisfaction of the approach position with traction. C-arm X-ray machine perspective, the satisfaction of the location (Figure 1), disinfection shop alone. After the midline approach using to expose the spinous process spine,[link widoczny dla zalogowanych], paraspinal muscles pushed to the sides,[link widoczny dla zalogowanych], until the exposed facet joints. Fixed positioning clip, for navigation and identification (Figure 2). Recognition and Verification puncture device, is recognized in the navigation to guide screw entry point and entry angle (Figure 3). And real-time monitoring (Figure 4). Sure into the nail length. Software can also be used to measure the virtual tool (Figure 5). Select the appropriate length of the pedicle screw, if necessary, reset the device can be used. Connection system, complete the operation. Postoperative radiography confirmed. Postoperative X-ray film and CT review of pedicle screw position.
This group of patients had six deviated pedicle screws (2.4%), 5 partial, but a partial inside, according to Andrew pedicle screw position classification standard CT [1 ] for the II level (break through the pedicle cortex of ≤ 2 mm). Intraoperative C-arm X-ray machine review found that, in time to adjust, after review of X-ray films and CT, screw position satisfaction. Single screws implanted for about 12 (10 ~ 15) min. Significantly reduced operation time, blood loss was no significant difference. No cerebrospinal fluid leakage and nerve stimulation screw-related complications. Waist circumference after 3 weeks under the protection of ambulation. Review of all patients were followed up for 6 to 18 months, an average of 12.6 months, no loosening of the plant, break off, 15 patients have been removed within the plant, a good recovery.
2 Discussion
2.1 real-time navigation of the value of the
1.3 Results
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