Usefulness of 3D Printed Models in the Management of Complex Craniovertebral Junction Anomalies: Choice of Treatment Strategy, Design of Screw Trajectory, and Protection of Vertebral Artery

Du, Yue-Qi; Qiao, Guangyu; Yin, Yong; Li, Teng; Tong, Huaiyu; Yu, Xinguang

doi:10.1016/j.wneu.2019.09.139

Cited by 10 publications

(4 citation statements)

References 29 publications

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“…which has deterred many young neurosurgeons, not to operate upon these patients (3,9). The recent use of patient specific 3D printed models of CVJ as a pre-operative and intra-operative reference has provided a means to understand the complex anatomy of CVJ (5) VRT images of the Vertebral Artery (VA) were helpful in each case to avoid its injury during the soft tissue dissection around the C1-C2 facets. Although the vertebral arteries were neither directly exposed nor injured in any of the cases, nevertheless, their courses were confirmed using vascular doppler (Mizuho 20 MHz Surgical Doppler System, Tokyo, 113-0033, Japan) during soft tissue dissection.…”

Section: Resultsmentioning

confidence: 99%

“…Various tools and techniques have been used to safeguard vertebral artery injuries in the surgeries of CVJ, which include Fluoroscopy, O-arm, intraoperative Computerized Tomography (CT) scan, Neuronavigation and more recently, 3-Dimensional (3D) printing, to better understand the anatomy and use it as a reference during surgery (3,5,10,11). Volume Rendering Technique (VRT) has been used in various surgical disciplines like Facio-maxillary, Cardio-thoracic and orthopaedics disciplines (2,4,9).…”

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confidence: 99%

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Volume rendering technique (vrt) for planning and learning cranio-vertebral junction (cvj) surgeries: technical note.

Shukla

Patidar²,

Garg³

et al. 2021

Turkish Neurosurgery

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AIM:To present the application of volume rendering technique (VRT) of computed tomography (CT) scan in cranio-vertebral junction (CVJ) surgeries. MATERIAL and METHODS:The authors used VRT images of CT scan in patients of congenital CVJ anomalies who were subjected to various surgeries through midline posterior approach. The screw entry points and courses of vertebral arteries were identified in relation to various landmarks on the VRT images, preoperatively and intra-operatively. RESULTS:A total of 15 patients of CVJ anomalies, who underwent surgeries through midline posterior approach, formed the study group. The screw entry points and courses of the vertebral arteries could be effectively identified in the surgical fields. CONCLUSION:We conclude that VRT images are an inexpensive and user friendly tool to identify the screw insertion points in the surgeries of CVJ anomalies. They also help in identifying the course of the vertebral artery in the surgical field. On the whole, their use makes the surgery in this region, safer.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Volume rendering technique (vrt) for planning and learning cranio-vertebral junction (cvj) surgeries: technical note.

Shukla

Patidar²,

Garg³

et al. 2021

Turkish Neurosurgery

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“…Besides, the 3D model facilitated the choice and sizing of the implants. In human medicine, the use of 3D printing technology is widely accepted and used in cervical vertebral stabilization surgeries, providing a high degree of accuracy and safety in implant placement (Ishikawa et al, 2011;Du et al, 2020). In veterinary medicine, there are few reports of the use of 3D models for the surgical planning of patients with congenital vertebral malformations (Kamishina et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Congenital dynamic cervical instability in a dog: the role of computed tomography and 3D printing to plan and optimize the surgical approach

et al. 2021

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“…Thanks to advances in 3D‐printing technology, the use of 3D‐printed anatomical models is becoming increasingly widespread in the medical field. A 3D‐printed 1:1 scale model makes it possible for surgeons to obtain a clear understanding of IAAD morphology tridimensionally, which is beneficial for surgical preplanning 9,10 . For this reason, the purpose of this retrospective study is: (i) to investigate the role of 3D‐printed models in understanding the anatomy of the surgical region and in formulating surgical strategies; (ii) to evaluate whether the use of 3D‐printed models can improve the efficiency of the operation, and whether it can help to reduce the operation duration and fluoroscopy time; and (iii) to analyze whether the use of 3D‐printed models can improve the accuracy of screw placement.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a Three‐Dimensional‐Printed Model in the Treatment of Irreducible Atlantoaxial Dislocation with Transoral Atlantoaxial Reduction Plate

et al. 2021

Orthopaedic Surgery

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Objective To evaluate the usefulness of a 3D‐printed model for transoral atlantoaxial reduction plate (TARP) surgery in the treatment of irreducible atlantoaxial dislocation (IAAD). Methods A retrospective review was conducted of 23 patients (13 men, 10 women; mean age 58.17 ± 5.27 years) with IAAD who underwent TARP from January 2015 to July 2017. Patients were divided into a 3D group (12 patients) and a non‐3D group (11 patients). A preoperative simulation process was undertaken for the patients in the 3D group, with preselection of the TARP system using a 3D‐printed 1:1 scale model, while only imaging data was used for the non‐3D group. Complications, clinical outcomes (Japanese Orthopaedic Association [JOA] and visual analogue score [VAS]), and image measurements (atlas–dens interval [ADI], cervicomedullary angle [CMA], and clivus‐canal angle [CCA]) were noted preoperatively and at the last follow up. Results A total of 23 patients with a follow‐up time of 16.26 ± 4.27 months were included in the present study. The surgery duration, intraoperative blood loss, and fluoroscopy times in the 3D group were found to be shorter than those in non‐3D group, with statistical significance. The surgery duration was 3.29 ± 0.45 h in the 3D group and 4.68 ± 0.90 h in the non‐3D group, and the estimated intraoperative blood loss was 131.67 ± 43.03 mL in the 3D group and 185.45 ± 42.28 mL in the non‐3D group. No patients received blood transfusions. The intraoperative fluoroscopy times were 5.67 ± 0.89 in the 3D group and 7.91 ± 1.45 in the non‐3D group. Preoperatively and at last follow up, JOA and VAS scores and ADI, CCA, and CMA were improved significantly within the two groups. However, no statistical difference was observed between the two groups. However, surgical site infection occurred in 1 patient in the 3D group, who underwent an emergency revision operation of the removal of TARP device and posterior occipitocervical fixation; the patient recovered 2 weeks after the surgery. In 2 patients in the traditional group, a mistake occurred in the placement of screws, with no neurological symptoms related to the misplacement. Conclusion Preoperative surgical simulation using a 3D‐printed real‐size model is an intuitive and effective aid for TARP surgery for treating IAAD. The 3D‐printed biomodel precisely replicated patient‐specific anatomy for use in complicated craniovertebral junction surgery. The information was more useful than that available with 3D reconstructed images.

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Usefulness of 3D Printed Models in the Management of Complex Craniovertebral Junction Anomalies: Choice of Treatment Strategy, Design of Screw Trajectory, and Protection of Vertebral Artery

Cited by 10 publications

References 29 publications

Volume rendering technique (vrt) for planning and learning cranio-vertebral junction (cvj) surgeries: technical note.

Volume rendering technique (vrt) for planning and learning cranio-vertebral junction (cvj) surgeries: technical note.

Congenital dynamic cervical instability in a dog: the role of computed tomography and 3D printing to plan and optimize the surgical approach

Usefulness of a Three‐Dimensional‐Printed Model in the Treatment of Irreducible Atlantoaxial Dislocation with Transoral Atlantoaxial Reduction Plate

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