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| Application of CT 3D Reconstruction and Thin-Slice Scanning in Idiopathic Scoliosis Correction Surgery |
| LUO Xiaoling, LIU Yuqin, LI Lan, et al |
| Sichuan Provincial Hospital of Traditional Chinese Medicine, Sichuan Chengdu 610000, China |
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Abstract Objective: To investigate the application of CT 3D reconstruction and thin-slice scanning in idiopathic scoliosis correction surgery. Methods: This retrospective study included 112 patients with idiopathic scoliosis who underwent elective correction surgery at our institution between June 2020 and June 2023. Patients were divided into two groups based on surgical approach: the freehand pedicle screw placement group (n=42), who received conventional anatomical landmark guidance with C-arm fluoroscopy, and the CT 3D guidance group (n=70), who received CT 3D reconstruction guidance combined with thin-slice scanning. The two groups were compared in terms of pedicle screw accuracy, intraoperative fluoroscopy count, blood loss, surgical time, and postoperative length of hospital stay. The visual analogue scale (VAS) for pain, Japanese Orthopaedic Association (JOA) score, and Cobb angle changes were recorded and compared pre- and postoperatively for both groups. Complications were also observed. Results: A total of 1192 pedicle screws were inserted in the CT 3D guidance group and 673 pedicle screws were inserted in the freehand pedicle screw placement group. The pedicle screw accuracy rate in the CT 3D guidance group was 95.71% (1141/1192), which was significantly higher than that in the freehand pedicle screw placement group [91.08% (613/673); P<0.05]. The CT 3D guidance group had fewer intraoperative fluoroscopies, less blood loss, and shorter surgical time compared to the freehand pedicle screw placement group (P<0.05). There was no significant difference in postoperative length of hospital stay between the two groups (P>0.05). Compared to preoperative values, both groups showed a decrease in VAS scores, an increase in JOA scores, and a decrease in main Cobb angles postoperatively (P<0.05). The CT 3D guidance group had a greater improvement in JOA scores and a greater reduction in main Cobb angles compared to the freehand pedicle screw placement group (P<0.05), while there was no significant difference in VAS score improvement between the two groups (P>0.05). No serious complications occurred in either group, and only one patient developed wound healing complications. Conclusion: CT 3D reconstruction and thin-slice scanning can effectively guide idiopathic scoliosis surgery, improving surgical quality, reducing intraoperative X-ray exposure, shortening surgical time, decreasing blood loss, and promoting postoperative recovery.
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2024, Vol. 30 
