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Translaminar facet joint screw insertion with a rapid prototyping guide template: a cadaver study.
Computer Assisted Surgery ( IF 1.5 ) Pub Date : 2019-01-21 , DOI: 10.1080/24699322.2018.1542027
Yuanwu Cao 1 , Wenjun Zhang 1 , Yun Liang 1 , Zhenzhou Feng 1 , Chun Jiang 1 , Zixian Chen 1 , Xiaoxing Jiang 1
Affiliation  

It is technically demanding and requires rich experience to insert the translaminar facet screw(TFS) via the paramedian mini-incision approach. It seems that it is easy to place the TFS using computer-assisted design and rapid prototyping(RP) techniques. However, the accuracy and safety of these techniques is still unknown. The aim of this study is to assess the accuracy and safety of translaminar facet screw placement in multilevel unilateral transforaminal lumbar interbody fusion using a rapid prototyping drill guide template system. A patient-matched rapid prototyping translaminar facet screw guide was examined in fourteen cadaveric lumbar spine specimens. A three-dimensional (3D) preoperative screw trajectory was constructed using spinal computed tomography scans, from which individualized guides were developed for the placement of translaminar facet screws. Following bone tunnel establishment, the 3D positioning of the entry point and trajectory of the screws was compared to the preoperative plan as found in the Mimics software.Among 60 trajectories eligible for assessment, no cases of clinically significant laminar perforation were found. The mean deviation between the planned and the actual starting points on spinous process was 1.22 mm. The mean tail and submergence angle deviation was found to be 0.68°and 1.46°, respectively. Among all the deviations, none were found to have any statistical significance. These results indicate that translaminar facet screw placement using the guide system is both accurate and safe.



中文翻译:

椎板小关节螺钉插入及快速成型指导模板:尸体研究。

通过半正中小切口方法插入椎板小平面螺钉(TFS),这对技术要求很高,并且需要丰富的经验。使用计算机辅助设计和快速成型(RP)技术似乎很容易放置TFS。但是,这些技术的准确性和安全性仍然未知。这项研究的目的是评估使用快速原型钻导模板系统在多级单侧经椎间孔腰椎椎体间融合术中椎板小平面螺钉植入的准确性和安全性。在十四具尸体腰椎标本中检查了与患者匹配的快速原型经椎板小平面螺钉引导器。使用脊柱计算机断层扫描扫描来构建术前的三维(3D)螺钉轨迹,从中开发了用于放置椎板小平面螺钉的个性化指南。建立骨隧道后,将入路点和螺钉轨迹的3D定位与Mimics软件中发现的术前计划进行比较。在60条可评估的轨迹中,未发现具有临床意义的层状穿孔的病例。棘突计划起点与实际起点之间的平均偏差为1.22 mm。平均尾部和浸没角偏差分别为0.68°和1.46°。在所有偏差中,没有发现具有统计学意义。这些结果表明,使用引导系统放置椎板小平面螺钉既准确又安全。根据Mimics软件中的术前计划,比较了螺钉的入口点和轨迹的3D定位。在符合评估条件的60条轨迹中,未发现具有临床意义的层状穿孔的病例。棘突计划起点与实际起点之间的平均偏差为1.22 mm。平均尾部和浸没角偏差分别为0.68°和1.46°。在所有偏差中,没有发现具有统计学意义。这些结果表明,使用引导系统放置椎板小平面螺钉既准确又安全。根据Mimics软件中的术前计划,比较了螺钉的入口点和轨迹的3D定位。在符合评估条件的60条轨迹中,未发现具有临床意义的层状穿孔的病例。棘突计划起点与实际起点之间的平均偏差为1.22 mm。平均尾部和浸没角偏差分别为0.68°和1.46°。在所有偏差中,没有发现具有统计学意义。这些结果表明,使用引导系统放置椎板小平面螺钉既准确又安全。棘突计划起点与实际起点之间的平均偏差为1.22 mm。平均尾部和浸没角偏差分别为0.68°和1.46°。在所有偏差中,没有发现具有统计学意义。这些结果表明,使用引导系统放置椎板小平面螺钉既准确又安全。棘突计划起点与实际起点之间的平均偏差为1.22 mm。平均尾部和浸入角偏差分别为0.68°和1.46°。在所有偏差中,没有发现具有统计学意义。这些结果表明,使用引导系统放置椎板小平面螺钉既准确又安全。

更新日期:2019-01-21
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