Shi Wenjie, Aini Mijiti, Dang Limin, Kahaer Alafate, Zhou Zhihao, Wang Yixi, Maimaiti Abulikemu, Wang Shuiquan, Guo Hailong, Rexiti Paerhati
Xinjiang Uygur Autonomous Region, Xinjiang Medical University, Urumqi, China.
Department of Orthopedics Second People's Hospital Kashgar District, Xinjiang Uygur Autonomous Region, Kashgar City, China.
Front Surg. 2022 Nov 2;9:1028276. doi: 10.3389/fsurg.2022.1028276. eCollection 2022.
Compared with traditional pedicle screw trajectory, cortical bone trajectory (CBT) increases the contact surface between the screw and cortical bone where the screw is surrounded by dense cortical bone, which does not deform remarkably due to degeneration. We aimed to provide detailed information about the improvement of three-dimensional (3D)-printed navigation templates for modified CBT screw placement in the lumbar spine and evaluate the safety and accuracy thereof.
Four human cadaveric lumbar spine specimens were selected. After CT scanning data were reconstructed to 3D models, either the left or right side of each specimen was randomly selected to establish a 3D-navigation template, mutually complemented with the surface anatomical structure of the lateral margin of the lumbar isthmus, vertebral plate, and spinous process. The corresponding 3D centrum was printed according to the CT scanning data, and a navigation template of supporting design was made according to modified cortical bone technique. The same template was used to insert CBT screws into 3D printed and cadaveric specimens. After the screws were inserted, the screw path of the 3D printed specimens was directly observed, and that of the anatomical specimens was scanned by CT, to determine the position and direction of the screws to analyze the success rate of screw placement.
Twenty cortical bone screws were placed in each of the 3D printed and anatomical specimens, with excellent rates of screw placement of 100% and 95%, respectively.
We report the easy, safe, accurate, and reliable use of a 3D-printed navigation template to carry out screw placement by modified cortical bone technique in the lumbar spine.
与传统椎弓根螺钉轨迹相比，皮质骨轨迹（CBT）增加了螺钉与皮质骨之间的接触面积，在该轨迹中螺钉被致密皮质骨包围，皮质骨不会因退变而发生明显变形。我们旨在提供有关改良CBT螺钉置入腰椎的三维（3D）打印导航模板改进的详细信息，并评估其安全性和准确性。
选取4具人类尸体腰椎标本。将CT扫描数据重建为3D模型后，随机选择每个标本的左侧或右侧建立3D导航模板，使其与腰峡部外侧缘、椎板和棘突的表面解剖结构相互补充。根据CT扫描数据打印相应的3D椎体，并根据改良皮质骨技术制作支撑设计的导航模板。使用相同的模板将CBT螺钉插入3D打印标本和尸体标本中。螺钉插入后，直接观察3D打印标本的螺钉路径，对解剖标本的螺钉路径进行CT扫描，以确定螺钉的位置和方向，分析螺钉置入的成功率。
在3D打印标本和解剖标本中各置入20枚皮质骨螺钉，螺钉置入优良率分别为100%和95%。
我们报告了使用3D打印导航模板通过改良皮质骨技术在腰椎进行螺钉置入操作简便、安全、准确且可靠。
