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使用 3D 打印患者专用钻头导向器在犬的腰骶部放置椎弓根螺钉的准确性。

Accuracy of Placement of Pedicle Screws in the Lumbosacral Region of Dogs Using 3D-Printed Patient-Specific Drill Guides.

机构信息

Neurology and Neurosurgery Service, Willows Veterinary Centre and Referral Service Solihull, West Midlands, United Kingdom.

Vet 3D, Coventry, West Midlands, United Kingdom.

出版信息

Vet Comp Orthop Traumatol. 2021 Jan;34(1):53-58. doi: 10.1055/s-0040-1716840. Epub 2020 Oct 16.

Abstract

OBJECTIVE

The aim of this study was to report the accuracy of pedicle screw placement using three-dimensional (3D)-printed, patient-specific drill guides in the lumbosacral region of dogs.

STUDY DESIGN

This was a retrospective study. Thirty-two pedicle screws were placed in five dogs. Medical records were reviewed between November 2015 and November 2018 for dogs showing clinical signs associated with cauda equina syndrome. Inclusion criteria included preoperative magnetic resonance imaging, pre- and postoperative computed tomography (CT) and dorsal stabilization, with pedicle screws placed using 3D-printed, patient-specific drill guides and polymethylmethacrylate. Screw placement was evaluated for medial or lateral breaching on postoperative CT.

RESULTS

Five dogs met the inclusion criteria. Four had degenerative lumbosacral stenosis and one had discospondylitis. All dogs had failed medical management prior to surgery. Of 32 bicortical pedicle screws placed, 30 were fully contained inside the pedicle and 2 were partially breaching the vertebral canal (less than one-third of the screw diameter). Postoperative CT revealed good alignment of L7-S1 in all planes.

CONCLUSION

This technique enabled an accurate and safe placement of pedicle screws in the lumbosacral region of dogs with lumbosacral disease. Three-dimensional, printed patient-specific drill guides are a safe and effective method of placing pedicle screws in dogs with lumbosacral disease.

摘要

目的

本研究旨在报告在犬腰骶部使用三维(3D)打印的患者特异性钻头导向器进行椎弓根螺钉放置的准确性。

研究设计

这是一项回顾性研究。在 2015 年 11 月至 2018 年 11 月期间,对出现马尾综合征相关临床症状的犬进行了研究。纳入标准包括术前磁共振成像、术前和术后计算机断层扫描(CT)以及背侧稳定,使用 3D 打印的患者特异性钻头导向器和聚甲基丙烯酸甲酯放置椎弓根螺钉。术后 CT 评估螺钉的内侧或外侧突破情况。

结果

符合纳入标准的犬有 5 只。其中 4 只为退行性腰骶狭窄,1 只为椎间盘炎。所有犬在手术前均经过了药物治疗。共放置了 32 枚双皮质椎弓根螺钉,其中 30 枚完全位于椎弓根内,2 枚部分突破椎管(小于螺钉直径的三分之一)。术后 CT 显示所有犬的 L7-S1 在所有平面上均排列良好。

结论

该技术能够在患有腰骶疾病的犬中准确、安全地放置椎弓根螺钉。3D 打印的患者特异性钻头导向器是一种安全有效的方法,可用于放置患有腰骶疾病的犬的椎弓根螺钉。

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