数控机床技术在下颈椎个体化导向模板制作中的应用

doi:10.13418/j.issn.1001-165x.2015.03.011

Abstract

Abstract:

Objective Using of computer aided design and CNC machine tool technology for individual guide templates of lower cervical pedicle screws provides a new method for processing. Methods According to pre-operative CT scan data, 3D reconstruction models of lower cervical vertebra were obtained by Mimics; a based on the 3D model, the individual guide templates were designed and were subsequently produced by a CNC machine. The templates were used for lower cervical vertebrae screw placement in cadavers. Subsequently, CT scan was performed to evaluate the screw position. Results All 10 K-wires were inserted into the cervical pedicles. The absolute deviations were (0.44±0.23) mm in axial plane and (0.37±0.20) mm in sagittal plane. In the simulated insertion, 9 screws position were in grade 1, 1 screw was in grade 2. Conclusion Pedicle screws placement assisted by individual guide templates is highly accurate and simple. It is a new alternative to lower cervical pedicle.

Key words: CNC, Guide templates, lower cervical, pedicle screws

References

[1] Gaines RJ. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders[J]. J Bone Joint Surg Am, 2000, 82(10):1458-1476.
[2] Neo M, Sakamoto T, Fujibayashi S, et al. The clinical risk of vertebral artery injury from cervical pedicle screws inserted in degenerative vertebrae[J]. Spine, 2005, 30(24):2800-2805.
[3] Lu S, Xu Y Q, 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.
[4] Ma T, Xu YQ, Cheng YB, et al. A novel computer-assisted drill guide template for thoracic pedicle screw placement: a cadaveric study[J]. Arch Orthop Trauma Surg, 2012, 132(1):65-72.
[5] Ferrari V, Parchi P, Condino S, et al. An optimal design for patient-specific templates for pedicle spine screws placement[J]. Int J Med Robot, 2013, 9(3):298-304.
[6] Lu S, Xu Y Q, Lu WW, et al. A novel patient-specific navigational template for cervical pedicle screw placement[J]. Spine, 2009, 34(26):E959-E966.
[7] Ryken TC, Owen BD, Christensen GE, et al. Image-based drill templates for cervical pedicle screw placement[J]. J Neurosurg Spine, 2009, 10(1):21-26.
[8] 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.
[9] Abumi K, Kaneda K. Pedicle screw fixation for nontraumatic lesions of the cervical spine[J]. Spine, 1997, 22(16):1853-1863.
[10]Kunz M, Rudan JF, Xenoyannis GL, et al. Computer-assisted hip resurfacing using individualized drill templates[J]. J Arthroplasty, 2010, 25(4):600-606.
[11] 覃炜，权正学，刘洋，等. 寰枢椎椎弓根螺钉个体化导向模板的研制与实验研究[J]. 中国修复重建外科杂志, 2010, 24(10):1168-1173.
[12] 段冶. 数控机床技术发展现状及趋势初探[J]. 科技创新与应用, 2014, (1):120.
[13] 刘大炜，汤立民. 国产高档数控机床的发展现状及展望[J]. 航空制造技术, 2014, (3):40-43.

Experimental study on individual guide templates produced by CNC machine tool technology assisted pedicle screws insertion in the lower cervical spines

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 12

Metrics

Comments

Recommended 0

[1]	Li Jianyang, Li Bo, Ouyang Bingping, Luo Chunshan, Ma Xiangyang, Zou Xiaobao, Lu Tingsheng. Correlation between the angle of fixation and the curvature of the lower cervical spine with posterior atlantoaxial fixation fusion [J]. Chinese Journal of Clinical Anatomy, 2023, 41(1): 92-96.
[2]	Peng Peng, Huang Gang, Zhu Meisong, Li Jianyi. Anatomical study of anterior pedicle cortical bone screw in lower cervical spine [J]. Chinese Journal of Clinical Anatomy, 2022, 40(5): 505-510.
[3]	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.
[4]	. Accuracy of patient-specific drill template cervical pedicle screws insertion via cortical bone trajectory [J]. Chinese Journal Of Clinical Anatomy, 2018, 36(2): 137-140.
[5]	YAN Bin, SUN Yong-jan, OUYANG Han-bin, YANG Yang, WU Yi, LING Qin-jie, HUANG Hua-jun, HUANG Wen-hua. Clinical application of accurate lumbar pedicle screws placement assisted by 3D printing navigation modules [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(2): 156-159.
[6]	XU Chu, WU Bu-ling, LI Jian-yi, BAI Yu-zhe, SONG Ying, MA Li-chao, TANG Lei. The experimental study on edentulous mandible implantation assisted by metal surgical guides based on computer numerical control technology [J]. Chinese Journal Of Clinical Anatomy, 2016, 34(3): 289-292.
[7]	ZHANG Shao-Jie, WANG Xing, LI Zhi-Jun, ZHANG Yuan-Zhi, GAO Chang, WANG Zhi-Jiang. The digital morphological study of lower cervical pedicle in children [J]. Chinese Journal Of Clinical Anatomy, 2014, 32(6): 662-665.
[8]	YAN Bin, ZHANG Guo-Dong, TUN Zhang-Lin, HU Jing, YANG Xiang, HUANG Wen-Hua. Experimental study on accurate placement of the lumbar pedicle screws assisted by 3D printing navigation module [J]. Chinese Journal Of Clinical Anatomy, 2014, 32(3): 252-255.
[9]	CENG Zhong-You, YAN Wei-Feng, TANG Hong-Chao, TUN Feng, ZHANG Jian-Jiao, JIN Cai-Yi. Surgery strategy of isthmic lumbar spondylolisthesis of grade Ⅱ or above [J]. Chinese Journal Of Clinical Anatomy, 2013, 31(5): 591-595.
[10]	SONG Ke, FU Mao-Qiang, KONG Xiang-Xue, LIANG Dong-Zhu, LIN Li-Jun, HUANG Zhi-Beng, LI Jian-Die, OU Yang-Jun. Biological-safe patient-specific navigation template of posterior transpedicular fixation of lower cervical vertebrae: in vitro study [J]. Chinese Journal Of Clinical Anatomy, 2012, 30(5): 509-512.
[11]	YANG Rui, HUANG Lin, LI Wei-Beng, TANG Yong, WANG Feng, SONG Bin, CHEN Keng, YAN De-Zhen, CHEN Hui-Yong. The changes of the intervertebral foramen following the degeneration of lower cervical spine intervertebral space evaluated by 3D laser scan and multiple planar dynamic measurement [J]. Chinese Journal Of Clinical Anatomy, 2011, 29(5): 527-531.
[12]	DUAN 　Yang, JIN An-Min, MIN Shao-Xiong, HU Kong-He, ZHANG 　Li. The evaluation of 3D reconstruction on transarticular screw placement in the lower cervical spine [J]. Chinese Journal Of Clinical Anatomy, 2010, 28(2): 170-.