ナビゲーションを用いた若手脊椎外科医による椎弓根スクリュー刺入精度

Accuracy of Navigated Pedicle Screw Insertion by a Junior Spine Surgeon without Spinal Surgery Experience

　若手脊椎外科医がnavigation system(以下navi)を用いて椎弓根スクリュー(以下PS)刺入を行った成績を解析し，脊椎手術経験の多い医師の結果と比較検討した．刺入PSは総計137本であり，穿破率は2.2％であった．Navi経験豊富な上級医のもとにnaviを用いてPS刺入を行えば，若手脊椎外科医であっても高い精度で安全にPS刺入が可能であった．若手脊椎外科医のPS刺入手技の習得や教育の面でもnaviは非常に有用である．

　The purpose of this study was to investigate pedicle screw placement accuracy during navigated surgery by a junior spine surgeon who had no spinal surgery experience.　A junior spine surgeon with no spinal surgery experience implanted a total of 137 pedicle screws by using a navigation system.　Postoperative computerized tomography was performed to evaluate screw placement, and the pedicle perforation rate was 2.2%.　There were no neurologic or vascular complications related to the pedicle screws.　The results demonstrated that pedicle screws can be placed safely and effectively by a junior spine surgeon who has no spinal surgery experience when instructed by a senior spine surgeon.　The results of this study suggest that navigation can be used as a surgical training tool for junior spine surgeons.