摘要
Abstract
Objective To explore the influence of intraoperative use of CT three-dimensional reconstruction combined with thin-slice scanning on surgical outcomes and short-term prognosis in patients with idiopathic scoliosis undergoing posterior spinal internal fixation correction.Methods A total of 172 patients with idiopathic scoliosis admitted to Qinhuangdao Hospital of Peking University Third Hospital from January 2022 to October 2024 were retrospectively enrolled.All patients underwent posterior internal fixation and correction surgery.According to the intraoperative location method,patients were divided into a control group(87 cases)and a study group(85 cases).The control group underwent C-arm fluoroscopy with free-hand screw placement during surgery,while the study group used CT three-dimensional reconstruction combined with thin-slice scanning for screw positioning.Surgical parameters(operation time,intraoperative blood loss,number of X-ray fluoroscopy events),surgical outcomes(Cobb angle,pelvic tilt angle,range of anterior flexion and posterior extension),functional recovery(Forced vital capacity[FVC],forced expiratory volume in one second[FEV1],FEV1/FVC ratio,Japanese Orthopaedic Association Assessment Score[JOA]),and complications were compared between groups.Patients were followed up for 6 months,using the Scoliosis Research Society-22(SRS-22)questionnaire to evaluate prognosis.Results Operation time,intraoperative blood loss,and X-ray fluoroscopy frequency were lower in the study group than in the control group[(275.73±54.38)min vs(310.70±62.98)min,P<0.05;(703.15±114.25)mL vs(802.33±120.86)mL,P<0.05;15(12,17)times vs 17(13,19)times,P<0.05].The pre-to postoperative changes in Cobb angle,pelvic tilt angle,range of anterior flexion,and posterior extension were greater in the study group than in the control group(P<0.05).Postoperative FVC,FEV1,and FEV1/FVC ratio increased compared to preoperative values in both groups(P<0.05),with no statistically significant intergroup difference(P>0.05).The postoperative JOA score was higher in the study group than in the control group[(24.15±2.10)points vs(23.38±2.25)points,P<0.05].The total complication rate showed no statistically significant difference between groups(P>0.05).After 6 months,SRS-22 scores for functional activity,psychological status,and treatment satisfaction were higher in the study group(P<0.05).Conclusion Using CT three-dimensional reconstruction combined with thin-slice scanning during posterior internal fixation and correction surgery for idiopathic scoliosis helps shorten operation time,reduce intraoperative radiation exposure and blood loss.Accurate positioning significantly improves surgical outcomes,enhances spinal function,and promotes favorable short-term prognosis.关键词
CT三维重建/薄层扫描/特发性脊柱侧凸/后路内固定矫形术/预后Key words
CT three-dimensional reconstruction/thin-slice scanning/idiopathic scoliosis/posterior internal fixation and correction surgery/prognosis
