Determining the accuracy of lumbar 4/5 pedicle screw entry point based on digital three-dimensional technology
- VernacularTitle:基于数字三维技术确定腰4/5椎弓根螺钉进钉点的精确性
- Author:
Shixun WU
1
;
Shizhang LIU
1
;
Ming LING
1
;
Xianglong DUAN
2
;
Zhengming SUN
1
;
Jiyuan SHI
1
Author Information
- Publication Type:Journal Article
- Keywords: lumbar vertebra; digital imaging; simulated surgery; pedicle screw; three-dimensional model
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(2):263-268
- CountryChina
- Language:Chinese
- Abstract: 【Objective】 To establish a digital model of lumbar 4 and lumbar 5 vertebral bodies through three-dimensional imaging technology so as to explore the precise placement of pedicle screws during the lumbar posterior internal fixation operation. 【Methods】 CT scan image data set of lumbar spine included six specimens. Then lumbar modeling was produced using Mimics software， implanting pedicle screws was simulated with the computer to determine the reliability of pedicle screw for herringbone crest method， Weinstein method， and Magerl method. 【Results】 This study included six specimens （4 males and 2 females）， with an average age of 42.83 years. The distance from the right Magerl entry point to the actual entry point of the lumbar 4 vertebrae was significantly greater than that of the left side. The distance from the left herringbone crest entry point of lumbar 4 vertebrae to the actual entry point was significantly greater than Weinstein method and Magerl method （P<0.001 and P<0.001）， and the distance from the right herringbone crest entry point of lumbar 4 vertebrae to the actual entry point was significantly greater than Weinstein method （P=0.003）. Both left and right abduction angles of lumbar 4 vertebrae were true abduction angle >Magerl abduction angle > Weinstein abduction angle > herringbone abduction angle. The distances of true-Weinstein and true-herringbone ridges on the left side of lumbar 5 vertebrae were significantly greater than those on the right side （P=0.002 and P=0.004）， and the Weinstein abduction angle on the right side of lumbar 5 vertebrae was greater than that on the left side （P=0.003）. For the left and right sides of lumbar 5 vertebrae， the distance from herringbone crest entry point to the actual entry point was significantly greater than that of Weinstein method and Magerl method （P<0.001 and P<0.001）， and the distance from the Magerl entry point to the real entry point was significantly greater than that of the Weinstein method. The abduction angle of left and right sides of lumbar 5 vertebrae was as follows： true abduction angle > Magerl abduction angle > Weinstein abduction angle > herringbone abduction angle. 【Conclusion】 Both Weinstein entry point and Magerl entry point for lumbar 4 and lumbar 5 vertebra are close to the real entry point. The Weinstein abduction angle and Magerl abduction angle of lumbar 4 and lumbar 5 vertebrae have minor differences compared with real abduction angle. Therefore， it is recommended that Weinstein method is the preferred choice for lumbar 4 pedicle screw placement， while Weinstein method or Magerl method is the preferred choice for lumbar 5 pedicle screw placement.
