London Health Science Centre, Victoria Hospital-London, Ontario, Canada; Westmead Hospital, Sydney, NSW, Australia.
London Health Science Centre, Victoria Hospital-London, Ontario, Canada.
World Neurosurg. 2021 May;149:e821-e827. doi: 10.1016/j.wneu.2021.01.092. Epub 2021 Feb 1.
To determine if 2-in-1 patient-specific laminectomy and drill guides can be safely used to perform laminectomy and pedicle screw insertion.
This was a cadaveric study designed to test novel 2-in-1 patient-specific laminectomy guides, with modular removable pedicle screw drill guides. Three-dimensional (3D) printing has not been applied to laminectomy. This cadaveric study tests novel 2-in-1 patient-specific laminectomy guides, with modular removable pedicle screw drill guides. Computed tomography (CT) scans of 3 lumbar spines were imported into 3D Slicer. Spinal models and patient-specific guides were created and 3D printed. The bones were cleaned to visualize and record the under surface of the lamina during laminectomy. Pedicle screws and laminectomies were performed with the aid of patient-specific guides. CT scans were performed to compare planned and actual screw and laminectomy positions.
Thirty screws were inserted in 15 lumbar vertebrae by using the integrated 2-in-1 patient-specific drill guides. There were no cortical breaches on direct examination, or on postoperative CT. Digital video analysis revealed the burr tip did not pass deep to the inner table margin of the lamina in any of the 30 laminectomy cuts. Average surgical time was 4 minutes and 46 seconds (standard deviation, 1 min 38 sec).
This study has explored the development of novel 2-in-1 patient-specific, 3D-printed laminectomy guides with integrated pedicle screw drill guides, which are accurate and safe in the laboratory setting. These instruments have the potential to simplify complex surgical steps, and improve accuracy, time, and cost.
确定 2 合 1 个体化椎板切除术和钻头导向器是否可安全用于椎板切除术和椎弓根螺钉置入术。
这是一项尸体研究，旨在测试新型 2 合 1 个体化椎板切除术导向器，其具有模块化可移动的椎弓根螺钉钻头导向器。三维（3D）打印尚未应用于椎板切除术。本尸体研究测试了新型 2 合 1 个体化椎板切除术导向器，其具有模块化可移动的椎弓根螺钉钻头导向器。将 3 个腰椎的 CT 扫描导入 3D Slicer。创建和 3D 打印脊柱模型和个体化导向器。对骨骼进行清洁，以可视化和记录椎板切除术过程中的椎板下表面。借助个体化导向器进行椎弓根螺钉和椎板切除术。进行 CT 扫描以比较计划和实际的螺钉和椎板切除术位置。
在 15 个腰椎中使用集成的 2 合 1 个体化钻头导向器插入了 30 个螺钉。直接检查或术后 CT 均未发现皮质破裂。数字视频分析显示，在 30 次椎板切除术中，磨头尖端均未深切入椎板内板的内缘。平均手术时间为 4 分 46 秒（标准差为 1 分 38 秒）。
本研究探索了新型 2 合 1 个体化、3D 打印椎板切除术导向器的开发，该导向器在实验室环境中具有准确性和安全性。这些器械有可能简化复杂的手术步骤，提高准确性、时间和成本效率。
