Comparative study between 3D guide plate assisted and free-hand insertion of anterior cervical transpedicular screw.
10.12200/j.issn.1003-0034.2021.01.009
- Author:
Jie LI
1
;
Liu-Jun ZHAO
1
;
Min-Zhe ZHENG
1
;
Kai-Feng GAN
1
;
Yi-Lei CHEN
1
;
Zong-Xian FENG
1
;
Ling-Xiao PAN
1
;
Jun-Xiang XU
1
;
Teng-di FAN
1
;
Jing-Yang CHEN
1
;
Feng-Dong ZHAO
1
Author Information
1. Department of Orthopaedics, Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China.
- Publication Type:Journal Article
- Keywords:
3D guide plate;
Anterior cervical transpedicular screw;
Cervical spine;
Rapid prototyping
- MeSH:
Adult;
Aged;
Bone Plates;
Cervical Vertebrae/surgery*;
Cross-Sectional Studies;
Female;
Humans;
Male;
Middle Aged;
Pedicle Screws;
Printing, Three-Dimensional
- From:
China Journal of Orthopaedics and Traumatology
2021;34(1):45-50
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare accuracy of anterior cervical pedicle screws between assist of rapid prototyping 3D guide plate and free-hand insertion, and evaluate the safety of two methods.
METHODS:Eight adult cervical cadaver specimens after formaldehyde immersion, including 4 males and 4 females, aged 32 to 65(40.3±5.6) years old. After X-ray examination to exclude bone damage and deformity, 4 of them (3D guide plate group) randomly selected were for CT scan to obtain DICOM format data, and the data was imported into Mimics software for model, designed the ideal entry point and nail path for anterior cervicaltranspedicular screw (ATPS). After obtaining the personalized guide plate of the nail channel, it was exported as STL data, and the individual guide plate was printed by rapid prototyping and 3D printing technology. In turn, with the assistance of 3D guide plates, one-to-one personalized ATPS screws were placed on the four lower cervical cadaver specimens. Another 4 (free-hand group) lower cervical cadaver specimens were implanted with ATPS screws using free-hand technique. All specimens were performed CT thin-layer scanning and three-dimensional reconstruction after operation. The Tomasino method was used to evaluate the safety of the screws on the CT cross-sectional and sagittal images, to determine whether there was a cortical puncture of the lower and inner edges of the pedicle. According to the CT rating results, gradeⅠandⅡwere safe, and grade Ⅲ- Ⅴ were dangerous.And the accuracy of screws was recorded and analyzed between two groups.
RESULTS:Two screws were inserted in each segment from C
CONCLUSION:The 3D printing rapid prototyping guide plate assisted insertion of the anterior cervical pedicle screw can significantly improve the accuracy and safety, and provide a theoretical basis for further clinical application.
