Is a patient-specific drill template via a cortical bone trajectory safe in cervical anterior transpedicular insertion?

Peng, Peng; Xu, Yafei; Zhang, Xintao; Zhu, Meisong; Du, Bingran; Li, Wenrui; Huang, Wenhua; Song, Jun Young; Li, Jianyi

doi:10.1186/s13018-018-0810-5

Cited by 8 publications

(7 citation statements)

References 34 publications

(42 reference statements)

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“…The accuracy of PDTs in facilitating C2TOPI is of vital importance. In the present study, we calculated the absolute value of the deviations from the centroids between the preoperative designs and postoperative measurements, which had been used in our previous studies [25–27] to show the actual deviations. Our study showed that the absolute deviations in the axial plane (0.79 ± 0.64 mm) and the sagittal plane (0.96 ± 0.51 mm) in the PDT group might be within an acceptable range for clinical application.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific drill template for C2 transoral pedicle insertion in complete reduction of atlantoaxial dislocation: cadaveric efficacy and accuracy assessments

et al. 2019

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Background The transoral atlantoaxial reduction plate (TARP) is an effective advance in the treatment of atlantoaxial dislocation (AAD) and can enable the performance of anterior atlantoaxial release, reduction, decompression, and internal fixation in a one-stage operation. However, accurate transoral C2 pedicle insertion (C2TOPI) remains a challenge. The aim of this study is to develop a grouped patient-specific drill template (PDT) specifically for AAD with complete reduction and, furthermore, to compare its efficacy and accuracy in facilitating C2TOPI. Methods After CT scanning, ten cadaveric C2 specimens were randomly assigned to two groups (the PDT and freehand group). A grouped PDT specifically for AAD with complete reduction was designed and manufactured. C2TOPI was performed using the PDT or the fluoroscopy-guided freehand technique. Postoperative CT scans were subsequently performed to analyze the deviations at the centroid of the cross section at the midpoint of the pedicle. Screw position grades were also assessed in both groups. Results Compared to the freehand group, the PDT group had a significantly shorter surgery time ( p < 0.001). Significant differences between the two groups were observed in the absolute value of the deviations at the centroid of the pedicle on either the axial or sagittal planes ( p < 0.05). No significant difference was found in the screw positions between the two groups ( p > 0.05); however, two unacceptable breaches (20%) occurred in the freehand group. Conclusion A specifically designed PDT could provide an accurate and easy-to-apply method for C2TOPI in AAD with complete reduction.

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Section: Discussionmentioning

confidence: 99%

Patient-specific drill template for C2 transoral pedicle insertion in complete reduction of atlantoaxial dislocation: cadaveric efficacy and accuracy assessments

et al. 2019

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“… 2018 Peng P et al. [ 76 ] J Orthop Surg Res 4 cadaver CBT screw fixation Bio-safe drill templates can facilitate cervical anterior transpedicular insertion with good feasibility and accuracy. 2018 Krämer M et al.…”

Section: Basic Types and Clinical Applications Of Orthopedic 3d Print...mentioning

confidence: 99%

“…On this basis, Peng et al. [ 76 ] developed a template for guiding cortical bone trajectory screws. It successfully improved the success rate of screw placement and reduced intraoperative complications.…”

Section: Basic Types and Clinical Applications Of Orthopedic 3d Print...mentioning

confidence: 99%

Clinical applications and prospects of 3D printing guide templates in orthopaedics

Meng

Wang

Sun

et al. 2022

Journal of Orthopaedic Translation

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“…Alternatively, a guidance system such as O-arm-based three-dimensional (3D) navigation, 3D model, navigation templates, Doppler donography, robotic guidance system, [7][8][9][10][11][12] or augmented reality-based navigation [13 14] is needed to prevent placement failure. The use of these resources is limited because of their high cost and steep associated learning curve however, and they cannot be widely applied in all kinds of hospitals.…”

Section: Introductionmentioning

confidence: 99%

A Novel Radiographic Analysis System for Subaxial Cervical Spine Pedicle Screw Placement

Ding

Zhou

et al. 2023

Preprint

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Background Precise pedicle screw placement of the subaxial cervical spine is difficult. Not every hospital is equipped with a guidance system that can provide effective help. Computed tomography (CT) scanning is almost a routine preoperative examination for cervical spine surgery in all hospitals. Appropriate measurement and analysis of the CT images could assist optimal cervical pedicle screw placement. The purpose of this study is to propose a new and universal method using computed tomography (CT) morphological parameters analysis to assist optimal cervical pedicle screw placement from C3 to C7. Methods A localization system with six parameters was designed based on preoperative CT reconstruction to guide subaxial cervical spine pedicle screw placement. The six parameters were distance from the starting point to the midline [D1], distance from the starting point to the lower edge of the inferior articular process [D2], transverse section angle [TSA], sagittal section angle [SSA], pedicle width [PW], and pedicle height [PH]. The six parameters were analyzed in 53 participants. Results Combining D1 and D2 could localize the entrance of the pedicle screw, and we concluded that D1 and TSA and D2 and SSA could be a new standard for determination of the transverse and sagittal orientation of the pedicle screw. The six parameters were closely related to the patient’s gender, height, and weight. PH and PW were linearly correlated and could guide selection of the appropriate pedicle screw. SSA was an independent parameter of the relevant vertebral body, and changes in SSA had nothing to do with the curvature or posture of the cervical spine. Conclusions Understanding and applying the six-parameter localization system are essential for achieving accurate and optimal pedicle screw placement in subaxial cervical spine, regardless of cervical sagittal alignment.

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Is a patient-specific drill template via a cortical bone trajectory safe in cervical anterior transpedicular insertion?

Cited by 8 publications

References 34 publications

Patient-specific drill template for C2 transoral pedicle insertion in complete reduction of atlantoaxial dislocation: cadaveric efficacy and accuracy assessments

Patient-specific drill template for C2 transoral pedicle insertion in complete reduction of atlantoaxial dislocation: cadaveric efficacy and accuracy assessments

Clinical applications and prospects of 3D printing guide templates in orthopaedics

A Novel Radiographic Analysis System for Subaxial Cervical Spine Pedicle Screw Placement

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