Accuracy of pedicle screw placement using patient-specific template guide system
| Autor: | Yasuhito Yahara, Hirohito Takeuchi, Yoshiharu Kawaguchi, Ryo Fujita, Shigeki Oshima, Masanori Fujiya, Itaru Oda |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Perforation (oil well) Effective solution 03 medical and health sciences 0302 clinical medicine Pedicle Screws medicine Humans Orthopedics and Sports Medicine Cervical fusion Pedicle screw Retrospective Studies Orthodontics 030222 orthopedics business.industry Patient specific equipment and supplies musculoskeletal system Neurovascular bundle Sagittal plane Vertebra surgical procedures operative medicine.anatomical_structure Spinal Fusion Cervical Vertebrae Surgery Spinal Diseases business 030217 neurology & neurosurgery |
| Zdroj: | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. 27(2) |
| ISSN: | 1436-2023 |
| Popis: | Background Despite repeated efforts for accurate cervical pedicle screw insertion, malpositioning of the inserted screw is commonly noted. To avoid neurovascular complications during cervical pedicle screw insertion, we have developed a new patient-specific screw guide system. This study aimed to evaluate the accuracy of cervical PS placement using the new patient-specific screw guide system. Methods This study is a retrospective clinical evaluation of prospectively enrolled patients. Seventeen consecutively enrolled patients who underwent posterior cervical fusion using the guide system were included. Firstly, three-dimensional planning of pedicle screw placement was done using simulation software. A screw guide for each vertebra was constructed preoperatively. A total of 77 screws were inserted with the guides. Postoperative computed tomography was used to evaluate pedicle perforation, and screw deviations, between the planned and actual screw positions, were measured. Results A total of 76 screws (98.7%) were completely inside the pedicle (C3-7), without neurovascular injuries. The mean screw deviations from the planned trajectory at the narrowest point of the pedicle and at the entry point in the axial and sagittal planes were 0.56 ± 0.43 mm and 0.43 ± 0.35 mm and 0.43 ± 0.30 mm and 0.63 ± 0.50 mm, respectively. There were no significant differences in any parameter at different spinal levels. Angular deviations in the sagittal and axial planes were 2.94 ± 2.04° and 2.53 ± 1.85°, respectively. Sagittal angular deviations tended to increase in the cranial vertebra (C3 and C4) compared to the middle cervical spine. Conclusions We demonstrated that our patient-specific screw guide is vital for guiding precise screw insertion in the cervical pedicle. This technique may be an effective solution for achieving precise screw insertion and reducing the incidence of complications. |
| Databáze: | OpenAIRE |
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