Feasibility and accuracy of computer-assisted individual drill guide template for minimally invasive lumbar pedicle screw placement trajectory |
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| Affiliation: | 1. Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang, 110016, Liaoning, China;2. State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning, 110016, China;3. State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China;4. State Key Lab of CAD&CG, Zhejiang University, Hangzhou, Zhejiang, 310013, China;1. Division of Orthopaedic Surgery, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway;2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway;1. Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Switzerland;2. AO Research Institute Davos, Switzerland;3. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland;4. The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom;5. Department of Trauma Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands;6. Department of Septic Surgery, Orthopaedic-Trauma Unit, Department for the Musculoskeletal System, CHUV, Lausanne, Switzerland;7. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, USA;8. Department of Orthopaedic and Trauma Surgery, University Hospital of Münster, Germany;9. Department of Orthopaedic Surgery, Virginia Commonwealth University, USA;10. Department of Trauma Surgery, University Hospitals Leuven, Belgium |
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| Abstract: | ![]()
ObjectiveTo discuss the feasibility and accuracy of a specific computer-assisted individual drill guide template (CIDGT) for minimally invasive lumbar pedicle screw placement trajectory (MI-LPT) through a bovine cadaveric experimental study.DesignA 3-D reconstruction model, including lumbar vertebras (L1–L5), was generated, and the optimal MI-LPTs were determined. A drill guide template with a surface made of the antitemplate of the vertebral surface, including the spinous process and the entry point vertebral surface, was created by reverse engineering and rapid prototyping techniques. Then, MI-LPTs were determined by the drill guide templates, and the trajectories made by K-wires were observed by postoperative CT scan.SettingGeneral Hospital of Shenyang Military Area Command of Chinese PLA.ResultsIn total, 150 K-wires for MI-LPTs were successfully inserted into L1-L5. The required mean time and fluoroscopy times between fixation of the template to the spinous process, entry point vertebral surface, and insertion of the K-wires for minimally invasive lumbar pedicle screw placement trajectories into each vertebra were 79.4 ± 15.0 s and 2.1 ± 0.8 times. There were no significant differences between the preoperative plan and postoperative assessment in the distance from the puncture to the midline and inclination angles according to the different levels (P > 0.05, respectively). The mean deviation between the preoperative plan and postoperative assessment in the distance from the puncture to the midline and inclination angles were 0.8 ± 0.5 mm and 0.9 ± 0.5°, respectively.ConclusionsThe potential use of the novel CIDGT, which was based on the unique morphology of the lumbar vertebra to place minimally invasive lumbar pedicle screws, is promising and could prevent too much radiation exposure intraoperatively. |
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| Keywords: | Lumbar Minimally invasive Pedicle screw Rapid prototyping Template |
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