Back to Search
Start Over
Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
- Source :
- Techniques in Orthopaedics (Rockville, Md.)
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- The cortical bone trajectory (CBT) screw technique yields effective mechanical and clinical results, improving the holding screw strength with a less invasive exposure. Accurate and safe screw placement is crucial. A patient-specific drill template with a preplanned trajectory was considered a promising solution; however, it is critical to assess the efficacy and safety of this technique. This study aims to evaluate the accuracy of patient-specific computed tomography (CT)-based rapid prototype drill guide templates for the CBT technique. CT scanning was performed in 7 cadaveric thoracolumbar spines, and a 3-dimensional reconstruction model was generated. By using computer software, we constructed drill templates that fit onto the posterior surface of thoracolumbar vertebrae with drill guides to match the CBT. In total, 80 guide templates from T11 to L5 were created from the computer models by using rapid prototyping. The drill templates were used to guide the drilling of CBT screws without any fluoroscopic control, and CT images were obtained after fixation. The entry point and direction of the planned and inserted screws were measured and compared. In total, 80 screws were inserted from T11 to L5. No misplacement or bony perforation was observed on postoperative CT scan. The patient-specific prototype template system showed the advantage of safe and accurate cortical screw placement in the thoracolumbar spine. This method showed its ability to customize the patient-specific trajectory of the spine, based on the unique morphology of the spine. The potential use of drill templates to place CBT screws is promising.
- Subjects :
- musculoskeletal diseases
Rapid prototyping
drill template
Perforation (oil well)
computer-assisted template
Screw placement
03 medical and health sciences
0302 clinical medicine
Medicine
Orthopedics and Sports Medicine
rapid prototyping
Fixation (histology)
030222 orthopedics
Drill
business.industry
equipment and supplies
musculoskeletal system
cortical bone screw
surgical procedures, operative
medicine.anatomical_structure
Novel Research Methods and Models
Trajectory
Cortical bone
Cadaveric spasm
business
030217 neurology & neurosurgery
Biomedical engineering
Subjects
Details
- ISSN :
- 08859698
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Techniques in Orthopaedics
- Accession number :
- edsair.doi.dedup.....3ef6af83bf5717146b2efa0013304a9c
- Full Text :
- https://doi.org/10.1097/bto.0000000000000285