Morphometric Comparisons Between the Pedicle and the Pedicle Rib Unit in the Immature Chinese Thoracic Spine

Tian, Naifeng; Xu, Huazi; Wang, Xiangyang; Chen, Qiao-Jie; Zheng, Li-Cheng

doi:10.1097/brs.0b013e3181c6d9ae

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…We measured the following parameters using the Star PACS System, which was proven to achieve accurate measurements in previous studies [ 8 , 18 ]:…”

Section: Methodsmentioning

confidence: 99%

The Accuracy of a Method for Printing Three-Dimensional Spinal Models

Shao

Wang

et al. 2015

PLoS ONE

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BackgroundTo study the morphology of the human spine and new spinal fixation methods, scientists require cadaveric specimens, which are dependent on donation. However, in most countries, the number of people willing to donate their body is low. A 3D printed model could be an alternative method for morphology research, but the accuracy of the morphology of a 3D printed model has not been determined.MethodsForty-five computed tomography (CT) scans of cervical, thoracic and lumbar spines were obtained, and 44 parameters of the cervical spine, 120 parameters of the thoracic spine, and 50 parameters of the lumbar spine were measured. The CT scan data in DICOM format were imported into Mimics software v10.01 for 3D reconstruction, and the data were saved in .STL format and imported to Cura software. After a 3D digital model was formed, it was saved in Gcode format and exported to a 3D printer for printing. After the 3D printed models were obtained, the above-referenced parameters were measured again.ResultsPaired t-tests were used to determine the significance, set to P<0.05, of all parameter data from the radiographic images and 3D printed models. Furthermore, 88.6% of all parameters of the cervical spine, 90% of all parameters of the thoracic spine, and 94% of all parameters of the lumbar spine had Intraclass Correlation Coefficient (ICC) values >0.800. The other ICC values were <0.800 and >0.600; none were <0.600.ConclusionIn this study, we provide a protocol for printing accurate 3D spinal models for surgeons and researchers. The resulting 3D printed model is inexpensive and easily obtained for spinal fixation research.

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“…We measured the following parameters using the Star PACS System, which was proven to achieve accurate measurements in previous studies [ 8 , 18 ]:…”

Section: Methodsmentioning

confidence: 99%

The Accuracy of a Method for Printing Three-Dimensional Spinal Models

Shao

Wang

et al. 2015

PLoS ONE

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“…However, pedicle violation resulted from malpositioned screw leading to potential harm to nearby vital structures, which prompted surgeons to search for the perfect strategy. Though alternative methods (e.g., transarticular screw [2], lateral mass [3], extrapedicular screw fixation [4,5]) were developed for better surgical outcome, surgeons were more prone to improve the pedicle screw insertion accuracy by trying various supporting methods (e.g., intraoperative monitoring [6,7], anatomical markers [13,24,26,47]). Nevertheless, none of the conventional methods was considered as the perfect intraoperative assisting method.…”

Section: Introductionmentioning

confidence: 99%

Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

et al. 2010

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Studies revealed that navigation systems that provided intraoperative assistance might improve pedicle screw insertion accuracy, and also implied that different systems provided different pedicle screw insertion accuracy. A systematic review and meta-analysis was conducted to focus on the pedicle screw insertion accuracy with or without the assistance of image-guided system, and the variance among the different navigation systems. Comparative studies were searched on pedicle screw insertion accuracy between conventional and navigated method, and among different navigation systems. A total of 43 papers, including 28 clinical, 14 cadaveric and 1 model studies, were included in the current study. For clinical articles, there were 3 randomized clinical trials, 4 prospective comparative studies and 21 retrospective comparative studies. The incidence of pedicle violation among computer tomography-based navigation method group was statistically significantly less than that observed among the conventional group (OR 95% CI, in vivo: 0.32-0.60; in vitro: 0.24-0.75 P \ 0.01). Two-dimensional fluoroscopybased navigation system (OR 95% CI, in vivo: 0.27-0.48; in vitro: 0.43-0.88 P \ 0.01) and three-dimension fluoroscopy-based navigation system (OR 95% CI, in vivo: 0.09-0.38; in vitro: 0.09-0.36 P \ 0.01) also obtained significant reduced screw deviation rate over traditional methods. Between navigated approaches, statistically insignificant individual and pooled RR values were observed for all in vivo subgroups. Pooled estimate of in vitro studies show that computer tomography-based and three-dimension fluoroscopy-based navigation system provided more accurate pedicle screw insertion over two-dimension fluoroscopy-based navigation system. Our review showed that navigation provided a higher accuracy in the placement of pedicle screws compared with conventional methods. The superiority of navigation systems was obvious when they were applied to abnormal spinal structure. Although no strong in vivo evidence has detected significantly different pedicle screw placement accuracy among the three major navigation systems, meta-analysis revealed the variance in pedicle screw insertion accuracy with different navigation methods.

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“…Besides, Liljenqvist et al [ 16 ] measured 26 patients with right-side thoracic curves using MRI and found significantly narrower pedicles on the concave side at the apex of the curve (range of 2.3–3.2 mm compared with convex side 3.9–4.4 mm), whereas the width of pedicle rib unit was wider when compared with the convex side (ranged from 11 mm in the cephalad aspect to 14 mm in the caudad aspect of the thoracic spine). Tian et al [ 17 ] also investigated the dimensions of the pedicle rib unit for normal children, reporting a significantly larger size of the corresponding pedicle rib unit provided a more ample space. Furthermore, the minimum value of maximal screw length of CBT screws insertion via pedicle rib unit was 6.27 mm (Table 3 ), which indicated that 5.5 mm CBT screws can be inserted correctly via the pedicle rib unit in all patients (Fig.…”

Section: Discussionmentioning

confidence: 99%

Cortical bone trajectory screws placement via pedicle or pedicle rib unit in the pediatric thoracic spine (T9-T12)

Xuan

Chen

et al. 2017

Medicine

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Thoracic cortical bone trajectory (CBT) screw fixation can maximize the thread contact with cortical bone, and it is 53.8% higher than that of the traditional pedicle screws. Moreover, it can also enable less tissue dissection and retraction for reduced muscle disruption.Eighty pediatric patients are divided into 4 age groups and their thoracic vertebrae are analyzed on computed tomography (CT) images. The maximal screw length, maximal screw diameter, screw diameter, and the cephalad angle are measured. The statistical analysis is performed using the Student's t-test and Pearson's correlation analysis.Maximal screw length increases from T9 to T12 and there are significant differences between girls and boys at T9, T10, T11, and T12 in majority of groups (P < 0.05). The maximal screw diameter and screw diameter increase from T9 to T12. The maximal screw diameter ranges from 6.27 mm to 10.20 mm, whereas the screw diameter ranges from 3.87 mm to 6.75 mm. Meanwhile, the maximum cephalad angle is 23.06° and the minimum is 13.11°. No statistically significant differences in the cephalad angle are found at all levels.Our study establishes the feasibility of 4.5 to 5.5 mm CBT screws fixation via pedicle or pedicle rib unit in the pediatric thoracic spine. The entry point of the pediatric thoracic CBT screws is 6 o’clock orientation of the pedicle. Findings of our study also provide insights into the screw insertion angle and screw size decision.

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Morphometric Comparisons Between the Pedicle and the Pedicle Rib Unit in the Immature Chinese Thoracic Spine

Cited by 6 publications

References 15 publications

The Accuracy of a Method for Printing Three-Dimensional Spinal Models

The Accuracy of a Method for Printing Three-Dimensional Spinal Models

Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

Cortical bone trajectory screws placement via pedicle or pedicle rib unit in the pediatric thoracic spine (T9-T12)

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