Wen Zhi-Jing, Lu Teng, Gao Zheng-Chao, Liu Jian-Tao, Wang Yi-Bin, Liang Hui, He Xi-Jing
The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China.
The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China;
Zhongguo Gu Shang. 2018 Aug 25;31(8):783-786. doi: 10.3969/j.issn.1003-0034.2018.08.019.
The cervical screw fixation has been used widely in the clinic setting due to the high fusion rate, immediate fixation of the surgical segment and good correction of the deformity. However, owing to the variation of anatomical structures and the narrow pedicle screws, it's rather difficult to implant the screws through traditional methods. The perforation rate of the screw is high, which can cause serious complications such as neurovascular injury. In recent years, rapid prototyping navigation templates have been reported in the appilication to assist cervical screw placement for improving the accuracy of screw placement. In this paper, we reviewed and summarized published literatures about navigation template assisted cervical screw implantation in the past 20 years, systematically introduced the methods of producing and using of navigation templates, the development of design concept and the status of application in cervical spine surgery. To date, relevant clinical and cadaveric studies confirm that the use of rapid prototyping navigation template assisted cervical screw placement in cervical surgery can reduce screw perforation rate, intraoperative ionizing radiation injury and operation time, which is worth applying in the clinical practice. However, specific clinical effects of different design types of navigation templates are not well summarized. As a result, more clinical and cadaveric studies comparing the accuracy and safety of navigation templates of different design types are needed to help clinicians select the appropriate navigation template for surgery.
颈椎螺钉固定因其融合率高、能立即固定手术节段以及能良好矫正畸形，已在临床中广泛应用。然而，由于解剖结构的变异以及椎弓根螺钉较窄，通过传统方法植入螺钉相当困难。螺钉穿孔率高，可导致神经血管损伤等严重并发症。近年来，有报道称快速成型导航模板在辅助颈椎螺钉置入方面的应用，以提高螺钉置入的准确性。在本文中，我们回顾并总结了过去20年中关于导航模板辅助颈椎螺钉植入的已发表文献，系统介绍了导航模板的制作和使用方法、设计理念的发展以及在颈椎手术中的应用现状。迄今为止，相关临床和尸体研究证实，在颈椎手术中使用快速成型导航模板辅助颈椎螺钉置入可降低螺钉穿孔率、术中电离辐射损伤和手术时间，值得在临床实践中应用。然而，不同设计类型导航模板的具体临床效果尚未得到很好的总结。因此，需要更多的临床和尸体研究来比较不同设计类型导航模板的准确性和安全性，以帮助临床医生选择合适的手术导航模板。
