Determination of optimal design of navigation templates for transpedicular implantation in the cervical and thoracic spine: results of cadaveric studies

Objective. To assess efficacy and safety of using a three-level navigation template in the surgical treatment of congenital spinal deformities. Material and Methods. Three-level navigation templates were used in surgical treatment of four consecutively operated 10-17-year-old patients with congenital scoliosis associated with thoracic hemivertebrae. The correctness of screw position was evaluated according to CT data using a 2-mm increment method: class 0-intraosseous screw position; class 1-the screw extends beyond the pedicle cortex by less than 2 mm; class 2-by 2-4 mm; and class 3-by more than 4 mm. Preoperative DICOM data were processed with free software. The model of target zone and navigation template were 3D printed and used in surgery. Results. Four of 16 (25 %) pedicles were narrower than 4.35 mm and were estimated as difficult for implantation with a planned violation of the integrity of the endplate. Perforation of the outer cortical layer took place in all these cases, and screw position corresponded to class 2 only in pedicle width of 1.9 mm. In pedicles wider than 4.35 mm, 11 of 12 (91.7 %) screws were implanted intraosseously. One screw extended beyond the pedicle cortex by 0.8 mm (class 1). Conclusion. Three-level navigation template can be considered as an effective means of positioning transpedicular screws in secondarily changed segments adjacent to anomalous one and confounding implantation. Free software is sufficient for preparing 3D-model of target zone and navigation template, and such a model is a highly informative reference object that is convenient to use during the operation.

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Application of three-level navigation template in surgery for hemivertebrae in adolescents

Kosulin

Elyakin

Kornievskiy

et al. 2020

Hir. pozvonoč.

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Comparison of pedicle screw placement using O-arm navigation and navigational templates in an animal model experiment

et al. 2020

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Assessment of the safety and accuracy of implantation of screws into the C2 vertebra using individual 3D-navigation matrices

Коваленко¹,

Rudenko²,

Кашин³

et al. 2020

Vopr. neirokhir.

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Determination of optimal design of navigation templates for transpedicular implantation in the cervical and thoracic spine: results of cadaveric studies

Abstract: Determination of optimal design of navigation templates for transpedicular implantation in the cervical and thoracic spine: results of cadaveric studies

Cited by 7 publications

References 17 publications

Application of three-level navigation template in surgery for hemivertebrae in adolescents

Application of three-level navigation template in surgery for hemivertebrae in adolescents

Comparison of pedicle screw placement using O-arm navigation and navigational templates in an animal model experiment

Assessment of the safety and accuracy of implantation of screws into the C2 vertebra using individual 3D-navigation matrices

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