Precision and safety of Multilevel Cervical Transpedicular Screw Fixation with 3D Patient-Specific Guides; A Cadaveric Study
Sallent, Andrea (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ramírez Valencia, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Catalá, Jordi (Institut Guirado)
Rodríguez Baeza, Alfonso (Universitat Autònoma de Barcelona. Departament de Ciències Morfològiques)
Bago, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
de Albert, Matías (Hospital Universitari Vall d'Hebron)
Vélez, Roberto (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2019
Resum:	The aim is to design a patient-specific instrument (PSI) for multilevel cervical pedicle screw placement from C2 to C7, as well as verifying reliability and reproducibility. Computed tomography (CT) scans were obtained from 7 cadaveric cervical spines. Using Mimics software, semiautomatic segmentation was performed for each cervical spine, designing a 3D cervical spine bone model in order to plan transpedicular screw fixation. A PSI was designed according to the previously cited with two cannulated chimneys to guide the drill. The guides were 3D printed and surgeries performed at the laboratory. Postoperative scans were obtained to study screw placement. Sixty-eight transpedicular screws were available for study. 61. 8% of all screws were within the pedicle or partially breached <4 mm. No differences were observed between cervical levels. None of these screws had neurovascular injury. Of the 27 screws with a grade 3 (screw outside the pedicle; 39. 7%), only 2 had perforation of the transverse foramen and none of them would have caused a neural injury. In conclusion, multilevel PSI for cervical pedicle screw is a promising technology that despite showing improvements regarding free-hand technique requires further studies to improve the positioning of the PSI and their accuracy.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Scientific reports, Vol. 9 (october 2019) , p. 15686, ISSN 2045-2322

DOI: 10.1038/s41598-019-51936-w
PMID: 31666550

7 p, 1.3 MB

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