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Study Design:
A prospective clinical trial.
Objective:
The m of this study was to develop an individualized navigation template for the precise insertion of lower cervical anterior transpedicular screws ATPS using a three-dimensional printing technique, med at enhancing safety and accuracy in cervical spine instrumentation procedures.
Background Data Summary:
Conventional fluoroscopic-guided manual screw insertion often results in misalignment of ATPS channels. There is an urgent need for accurate techniques to ensure correct placement during cervical instrumentation surgeries.
Methods:
Twenty adult cadavers 10 males and 10 females, with a mean age of 50.29 ± 6.98 years were utilized for preoperative computed tomography scans that were followed by postoperative evaluations. A three-dimensional lower cervical spine model was reconstructed using Mimics software to measure critical parameters related to ATPS screws and generate an optimal screw channel template along with a prototype via 3D printing. The navigation template guided bilateral ATPS insertion into the cadavers.
Key Findings:
The mean outer width of pedicles was determined to be 5.31 ± 1.23 mm, while the average height was found at 6.78 ± 1.10 mm. The optimal screw channel dimensions obtned via the optimal entry point were an average length of 36.34 ± 4.39 mm, a sagittal angle of 40.67°±5.10°, and an axial angle of 93.7°±7.96°. The safe adjustable ranges for the angles were calculated to be 3.89°±1.13° sagittal and 5.64° ± 0.97° axial. The accuracy of screw placement was confirmed, with an axial deviation of 99.5 and a sagittal accuracy at 97. The mean deviations in the X, Y, and Z axes were calculated as 0.39 ± 0.43 mm, 0.21 ± 0.41 mm, and 0.29 ± 0.14 mm respectively P 0.05.
:
An individualized ATPS navigation template was successfully developed using Mimics software and a three-dimensional printing technique based on preoperative computed tomography scans for enhanced precision in screw insertion procedures.
Level of Evidence: Level IV
Copyright ? 2018 Wolters Kluwer Health, Inc. All rights reserved.
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This article is reproduced from: https://journals.lww.com/spinejournal/fulltext/2018/03150/preparation_and_assessment_of_an_individualized.7.aspx?generateEpub=Article%7Cspinejournal:2018:03150:00007%7C10.1097/brs.0000000000002341%7C
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3D Printed Cervical Screw Navigation Template Individualized Spine Instrumentation Accuracy Precise Lower Cervical Screw Insertion Method Preoperative CT Scan Based Technique Enhanced Safety in Cervical Surgery Procedures Advanced Navigation for ATPS Placement