The application of a computer-assisted thermoplastic membrane navigation system in screw fixation of the sacroiliac joint – A clinical study

Zheng, Zhong; Zhang, Yingze; Hao, Jiandong; Zhai, Fushan; Su, Yanling; Pan, Jinshe

doi:10.1016/j.injury.2011.12.022

Cited by 13 publications

(18 citation statements)

References 14 publications

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“…As such, improving the accuracy of placement of the guide wires using the conventional method increases both intra-operative time and radiation exposure, which limits the use of this iterative approach for accurate guide wire placement in clinical practice. Different assistive tools have been used to improve the accuracy and efficiency in placing guide wires, including the use of multidimensional fluoroscopy [ 20 ], an internal template [ 8 , 9 ], thermoplastic membrane navigation [ 21 ], and computer-assisted navigation [ 5 , 6 , 17 , 22 ]. Our external template is distinctive from these assistive approaches, with greater pre-operative time taken to design and print the navigation template, which avoids the need for repeated fluoroscopy during the surgery and reduces the overall operative time.…”

Section: Discussionmentioning

confidence: 99%

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study

Yang

Yao

Chen

et al. 2018

BMC Musculoskelet Disord

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BackgroundIliosacral screw fixation is a popular method for the management of posterior pelvic ring fractures or dislocations, providing adequate biomechanical stability. Our aim in this study was to describe the use of a new patient-specific external template to guide the insertion of iliosacral screws and to evaluate the efficacy and safety of this technique compared with the conventional fluoroscopy-guided technique.MethodsThis was a retrospective study of patients with incomplete or complete posterior pelvic ring disruptions who required iliosacral screw fixation. For analysis, patients were divided into two groups: the external template group (37 screws in 22 patients) and the conventional group (28 screws in 18 patients). The operative time per screw, radiation exposure time and the rate of screw perforation (accuracy) were compared between groups. In the external template group, the difference between the actual and planned iliosacral screw position was also compared.ResultsIn the conventional group, the average operative time per screw was 39.7 ± 10.6 min, with an average radiation exposure dose of 1904.0 ± 844.5 cGy/cm2, with 4 cases of screw perforation. In the external template group, the average operative time per screw was 17.9 ± 4.7 min, with an average radiation exposure dose of 742.8 ± 230.6 cGy/cm2 and 1 case of screw perforation. In the template group, the mean deviation distance between the actual and planned screw position was 2.75 ± 1.0 mm at the tip, 1.83 ± 0.67 mm in the nerve root tunnel zone and 1.52 ± 0.48 mm at the entry point, with a mean deviation angle of 1.73 ± 0.80°.ConclusionsThe external template provides an accurate and safe navigation tool for percutaneous iliosacral screw insertion that could decrease the operative time and radiation exposure.

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Section: Discussionmentioning

confidence: 99%

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study

Yang

Yao

Chen

et al. 2018

BMC Musculoskelet Disord

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“…Some surgeons have reported the results of the management of sacroiliac dislocation by using iliosacral screws fixation [20][21][22][23][24][25][26][27]. This simple internal fixation is useful for stabilization of sacroiliac dislocation, whereas the complicated anatomy of the sacral foramen causes a risk of nerve injury because of screw placement, and the acquired stability may be not sufficient in the absence of the support from external fixation.…”

Section: Discussionmentioning

confidence: 99%

Internal Fixation of Sacroiliac Joint via Posterior Approach in Management of Posterior Pelvic Injuries

Aly¹

2017

JOBD

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Object: Sacroiliac dislocation frequently poses a complex problem for the surgical management and stabilization because of the anatomical and biomechanical factors of this transition zone between the spine and pelvis. The authors had used a modification of the Galveston technique, originally described by Allen and Ferguson in the treatment of scoliosis, to achieve rigid spinal-pelvic fixation in patient's sacroiliac dislocation with vertical and rotational shear.Methods: Twelve patients who had required spinal-pelvic fixation secondary to sacroiliac dislocation and instability fixation was achieved by intraoperative placement of S1 pedicle screws and contoured titanium rods bilaterally into the ilium.Results: During the follow-up period of18 to 36 months (average 26 months), Postoperative posterior fracture reduction was excellent in 9 patients (75%), good in 2 (17%) and fair in 1 patient (8%) (7). Conclusion:The combined use of S1 pedicle screws and the Galveston technique provided immediate stability and sufficient reduction of sacroiliac dislocation.

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“…However, the effective radiation dose was higher than fluoroscopic-assisted techniques. Zhanle et al [10] conducted a similar study, but used a thermoplastic membrane navigation system (n=13) for patients with sacroiliac joint fractures or dislocations. They also utilized a control group (n=13) receiving fluoroscopic guidance and found that their thermoplastic Mean and 95% confidence interval are reported; EP = Entry Point; TP = Target Point; R = Right; L = Left; C = Coccyx; S = L5 spinous process; P = Sacral Promontory; T = Trajectory where T1 and T2 represents the distance between the trajectories.…”

Section: Discussionmentioning

confidence: 99%

“…Box 112727, Gainesville, Florida 32601, Tel: 352-273-7434; Fax: 352 273 7388; E-mail: macmim@ortho.ufl.edu trajectory due to obesity, bowel gas, or contrast media and the level of technical skills required [2,3]. Computed tomography (CT) scans present a less technically demanding option for trajectory mapping and have been studied extensively [3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Merging Sacroiliac Fusion Computed Tomography Preoperative Planning to Original Computed Tomography Scans

Alvin

Yang²,

MacMillan³

2013

TOSPINEJ

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Background: Spinal merging has been done with preoperative CT scans merged with fluoroscopic imaging. However, preoperative and intraoperative CT scans have not been merged for the purposes of transferring a plan. If spine surgeons can create the optimal surgical pathway before surgery and then merge the pre-planned pathway onto the real patient CT scan in the operating room, the result will be efficiency and better time management for the spine surgeon. Our objective was to analyze the feasibility of merging computed tomography (CT) preplanned with sacroiliac fusion iliosacral screw trajectories with the original CT scans. Methods: Twenty-seven patients were identified from the institutional Faculty Group Practice who had undergone CT scans in the pelvic region. The pelvic CT scans were transferred to Medtronic's StealthStation ® , which allowed for analysis in coronal, sagittal, and axial sections. Three trajectories were mapped out, representing three working pathways for fixation. The position of the trajectories was localized by measuring their distance from anatomic landmarks. The CT scan with the planned trajectories was merged with the original CT scan. The same measurements made pre-merge were performed post-merge to check for the accuracy of the merging process. Results: Post-merge measurements were nearly identical to pre-merge measurements, with a maximum difference of ± 0.1 mm. No significant differences existed between pre-merge and post-merge measurements for any of the trajectories Conclusion: The merging of preplanned trajectory CT scans with intraoperative CT scans is a highly accurate technique. Clinical relevance: If this technique can be replicated by merging actual pre-operative CT scans with actual intraoperative scans, it could save time and expense. This would benefit the patient because time under anesthesia would be reduced.

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The application of a computer-assisted thermoplastic membrane navigation system in screw fixation of the sacroiliac joint – A clinical study

Cited by 13 publications

References 14 publications

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study

Internal Fixation of Sacroiliac Joint via Posterior Approach in Management of Posterior Pelvic Injuries

Feasibility of Merging Sacroiliac Fusion Computed Tomography Preoperative Planning to Original Computed Tomography Scans

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