经口咽枢椎椎弓根逆向精确置钉的个性化组合式导航模板的研究

doi:10.13418/j.issn.1001-165x.2018.06.014

Chinese Journal Of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (6): 669-673.doi: 10.13418/j.issn.1001-165x.2018.06.014

Previous Articles Next Articles

Experimental study on the grouped individual guide template assisted C2 transoral pedicle placement

ZHU Mei-song¹, PENG Peng², ZHOU Xiao-qi¹, SU Ze-xin¹, LI Si-jing¹,LI Jian-yi ^2,3, LIN Li-jun¹

1.Department of Joint and Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China;2.Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou 510515, China;3.Nanhai Hospital, Southern Medical University, Foshan 528244，China

Received:2018-01-31 Online:2018-11-25 Published:2018-12-29

Abstract

Abstract:

Objective　Using of 3D reconstruction, computer aided design and rapid prototyping(RP)technology to design and manufacture a novel grouped individual guide template for assisting C2 transoral pedicle placement.　Methods　After CT scanning of 4 adult cadaveric cervical specimens, 3D reconstruction models of upper cervical vertebrae were obtained by Mimics. Then 3D models of C1, C2 and the TARP were imported into Solidworks 2014 to design a grouped individual guide template for AAD. With the technology of rapid prototyping, the grouped individual guide template for AAD was manufactured. The templates were used for C2 transoral pedicle placement in cadavers. Subsequently, CT scan was performed to evaluate the screw position.　Results　All 8 K-wires were inserted into the cervical pedicles. The absolute deviations were (0.85±0.70) mm in axial plane and (0.88±0.53) mm in sagittal plane. No significant differences of the absolute deviations was observed on both the axial and sagittal planes（P>0.05）. In the classification of screw position, 7 screws position were in Type I, and 1 screw was in Type II.　Conclusion　C2 transoral pedicle placement assisted by the grouped individual guide template is highly accurate and simple. It is a new alternative to C2 transoral pedicle placement.

Key words: Transoral atlantoaxial reduction plate, 　Atlantoaxial dislocation, 　Individual guide templates, 　 C2 transoral pedicle placement

ZHU Mei-song, PENG Peng, ZHOU Xiao-qi, SU Ze-xin, LI Si-jing,LI Jian-yi, LIN Li-jun. Experimental study on the grouped individual guide template assisted C2 transoral pedicle placement[J]. Chinese Journal Of Clinical Anatomy, 2018, 36(6): 669-673.

References

[1] Yin QS, Li XS, Bai ZH, et al. An 11-year review of the TARP procedure in the treatment of atlantoaxial dislocation[J]. Spine, 2016, 41(19): E1151-E1158.
[2] Xu J, Yin Q, Xia H, et al. New clinical classification system for atlantoaxial dislocation[J]. Orthopedics, 2013, 36(1): e95-e100.
[3] Ai FZ, Yin QS, Xu DC, et al. Transoral atlantoaxial reduction plate internal fixation with transoral transpedicular or articular mass screw of C2 for the treatment of irreducible atlantoaxial dislocation[J]. Spine, 2011, 36(8): E556-E562.
[4] Xu R, Kang A, Ebraheim NA, et al. Anatomic relation between the cervical pedicle and the adjacent neural structures[J]. Spine (Phila Pa 1976), 1999, 24(5): 451-454.
[5] Bransford RJ, Russo AJ, Freeborn M, et al. Posterior C2 instrumentation: accuracy and complications associated with four techniques[J]. Spine, 2011, 36(14): E936-E943.
[6] Bydon M, Mathios D, Macki M, et al. Accuracy of C2 pedicle screw placement using the anatomic freehand technique[J]. Clin Neurol Neurosurg, 2014, 125: 24-27.
[7] Tessitore E, Bartoli A, Schaller K, et al. Accuracy of freehand fluoroscopy-guided placement of C1 lateral mass and C2 isthmic screws in atlanto-axial instability[J]. Acta Neurochir(Wien), 2011, 153(7): 1417-1425.
[8] Ondra SL, Marzouk S, Ganju A, et al. Safety and efficacy of C2 pedicle screws placed with anatomic and lateral C-arm guidance[J]. Spine (Phila Pa 1976), 2006, 31(9): E263-E267.
[9] Lu S, Xu YQ, Chen GP, et al. Efficacy and accuracy of a novel rapid prototyping drill template for cervical pedicle screw placement[J]. Comput Aided Surg, 2011, 16(5): 240-248.
[10] Sugawara T, Higashiyama N, Kaneyama S, et al. Multistep pedicle screw insertion procedure with patient-specific lamina fit-and-lock templates for the thoracic spine: clinical article[J]. J Neurosurg Spine, 2013, 19(2): 185-190.
[11] Jiang L, Dong L, Tan M, et al. A modified personalized image-based drill guide template for atlantoaxial pedicle screw placement: aclinical study[J]. Med Sci Monit, 2017, 23: 1325-1333.
[12] Lu S, Xu YQ, Lu WW, et al. A novel patient-specific navigational template for cervical pedicle screw placement[J]. Spine (Phila Pa 1976), 2009, 34(26): E959-E966.
[13] Lu S, Zhang YZ, Wang Z, et al. Accuracy and efficacy of thoracic pedicle screws in scoliosis with patient-specific drill template[J]. Med Biol Eng Comput, 2012, 50(7): 751-758.
[14] Kong X, Tang L, Ye Q, et al. Are computer numerical control (CNC)-manufactured patient-specific metal templates available for posterior thoracic pedicle screw insertion? Feasibility and accuracy evaluation[J]. Eur Spine J, 2017, 26(11): 2927-2933.
[15] Fu M, Lin L, Kong X, et al. Construction and accuracy assessment of patient-specific biocompatible drill template for cervical anterior transpedicular screw (ATPS) insertion: an in vitro study[J]. PLoS One, 2013, 8(1): e53580.

Experimental study on the grouped individual guide template assisted C2 transoral pedicle placement

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 0

Metrics

Comments

Recommended 0