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A novel technique for C1-C2 posterior screw insertion using patient-specific guides created by CT-based 3D printing.
- Source :
-
Nagoya journal of medical science [Nagoya J Med Sci] 2024 Aug; Vol. 86 (3), pp. 487-496. - Publication Year :
- 2024
-
Abstract
- C1-C2 fixation has been developed for the rigid fusion of atlantoaxial instability. C1 lateral mass screw (C1 LMS)-C2 pedicle screw fixation is used more frequently due to its rigid fixation and high bone fusion rate. However, C1 screw placement is relatively unsafe even with recently developed image-based navigation systems. Patient-specific screw guide templates (PSGT) were developed to improve the accuracy and safety of C1 screw placement. Herein, we investigated the outcomes of the C1-C2 posterior fixation technique using PSGT. This was a retrospective study of six patients who underwent posterior cervical spinal fusion using the PSGT between January 2022 and April 2023. Operative time, estimated blood loss, intraoperative radiation dose, surgical cost, and screw placement accuracy were evaluated and compared with those achieved with preoperative CT-based navigation (navigation group, n = 15). Screw accuracy was assessed using Neo's classification. PSGT showed good results, although the differences were not statistically significant (operation time: 104.3 ± 9.7 min vs 116.4 ± 20.8 min; estimated blood loss: 56.7 ± 72.4 mL vs 123.2 ± 162.3 mL; and radiation dose: 1.8 ± 1.2 mSv vs 2.6 ± 0.8 mSv, respectively). PSGT was particularly better in terms of the accuracy of C1 LMS (PSGT: 100%, navigation: 83.3%). The deviation at the entry point was minimal, and the difference between the sagittal and transversal angles from the preoperative plan was small. We investigated the clinical efficacy of using the PSGT for C1-C2 posterior fixation. PSGT improved the accuracy of C1 LMS insertion.<br />Competing Interests: The authors declare that there are no relevant conflicts of interest.
- Subjects :
- Humans
Male
Female
Middle Aged
Retrospective Studies
Aged
Pedicle Screws
Adult
Atlanto-Axial Joint surgery
Atlanto-Axial Joint diagnostic imaging
Bone Screws
Joint Instability surgery
Joint Instability diagnostic imaging
Operative Time
Surgery, Computer-Assisted methods
Printing, Three-Dimensional
Spinal Fusion methods
Spinal Fusion instrumentation
Tomography, X-Ray Computed methods
Cervical Vertebrae surgery
Cervical Vertebrae diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 2186-3326
- Volume :
- 86
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nagoya journal of medical science
- Publication Type :
- Academic Journal
- Accession number :
- 39355356
- Full Text :
- https://doi.org/10.18999/nagjms.86.3.487