Modified drilling template for placement of cervical anterior transpedicular screws
10.3760/cma.j.issn.1671-7600.2018.06.009
- VernacularTitle:改良版颈椎前路椎弓根螺钉导航模板的可行性研究
- Author:
Liran WANG
1
;
Liujun ZHAO
;
Yongjie GU
;
Liang YU
;
Jinjiong HONG
;
Jihui ZHANG
;
Leining WANG
;
Guanyi LIU
;
Weihu MA
Author Information
1. 315040,宁波市第六医院脊柱外科
- Keywords:
Cervical vertebrae;
Bone screws;
3D printing technology;
Template
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(6):504-509
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the accuracy in placement of cervical anterior transpedicular screws (ATPS) under the guidance of our modified drilling template.Methods Eight wet cadaveric specimens of adult cervical spine,4 male and 4 female ones,were used for this experiment.Data of CT thin layer scanning of the cervical specimens in DICOM format were imported into software Mimics 17.0.After 3D models of the cervical vertebrae were reconstructed,the optimal trajectory was designed for ATPS placement in the transparent mode of the 3D models.Normal and our modified drilling templates for ATPS placement were designed and manufactured by 3D printing.The 2 kinds of drilling templates were used to assist ATPS placement onto one cervical vertebra,with laterality randomized.Altogether 64 pieces of ATPS were placed,with 32 ones for each drilling template.Postoperative CT scanning was conducted to evaluate the accuracy in ATPS placement.The 2 kinds of ATPS template were compared in terms of the deviations between actual and ideal trajectories in direction (caudal-angle and extroversive-angle) and position (X and Y axes) of the entry point.Results Our modified drilling template led to one screw penetrating the pedicle cortical bone while the normal drilling template led to 4 screws penetrating the pedicle cortical bone,yielding an accuracy rate of 96.9％ and of 87.5％ respectively.The extroversive-angle deviation (0.72°±0.69°),caudal-angle deviation (0.91°±0.70°),X axis shift (0.53 ±0.40 mm) and Y axis shift (0.54 ±0.42 mm) related to the modified template were all significantly smaller than those related to the normal template (1.16° ± 0.70°,1.49°±0.68°,0.88±0.40mm,1.22±0.42mm,respectively) (P ＜0.05).Conclusion Compared with a normal ATPS template,our modified drilling template for ATPS may be advantageous in better fitness,greater stability,increased accuracy in screw placement,and protection of adjacent discs.
