Section of Small Animal Clinical Studies, University College Dublin, Dublin, Ireland.
Department of Veterinary Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Vet Surg. 2023 Jul;52(5):648-660. doi: 10.1111/vsu.13958. Epub 2023 Apr 18.
To compare pin placement accuracy, intraoperative technique deviations, and duration of pin placement for pins placed by free-hand probing (FHP) or 3D-printed drill guide (3DPG) technique.
Four greyhound cadavers.
Computed tomography (CT) examinations from T6-sacrum were obtained for determination of optimal pin placement and 3DPG creation. Two 3.2/2.4-mm positive profile pins were inserted per vertebra, one left and one right from T7-L7 (FHP [n = 56]; 3DPG [n = 56]) by one surgeon and removed for repeat CT. Duration of pin placement and intraoperative deviations (unanticipated deviations from planned technique) were recorded. Pin tracts were graded by two blinded observers using modified Zdichavsky classification. Descriptive statistics were used.
A total of 54/56 pins placed with 3DPGs were assigned grade I (optimal placement) compared with 49/56 pins using the FHP technique. A total of 2/56 pins placed with 3DPGs and 3/56 pins using the FHP technique were assigned grade IIa (partial medial violation). A total of 4/56 pins placed using the FHP technique were assigned grade IIIa (partial lateral violation). No pins were assigned grade IIb (full medial violation). Intraoperative technique deviations occurred with 6/56 pins placed using the FHP technique and no pins with 3DPGs. Overall, pins were placed faster (mean ± SD 2.6 [1.3] vs. 4.5 [1.8] min) with 3DPGs.
Both techniques were accurate for placement of spinal fixation pins. The 3DPG technique may decrease intraoperative deviations and duration of pin placement.
Both techniques allow accurate pin placement in the canine thoracolumbar spine. The FHP technique requires specific training and has learning curve, whereas 3DPG technique requires specific software and 3D printers.
比较徒手探查（FHP）或 3D 打印导板（3DPG）技术下的置钉准确性、术中技术偏差和置钉时间。
4 只灰狗尸体。
对 T6-骶骨进行计算机断层扫描（CT）检查，以确定最佳置钉位置和 3DPG 制作。由一位外科医生从 T7-L7 左右各插入 2 根 3.2/2.4mm 阳性轮廓钉（FHP [n=56]；3DPG [n=56]），然后取出进行重复 CT。记录置钉时间和术中偏差（与计划技术不符的意外偏差）。两名盲法观察者使用改良 Zdichavsky 分级法对钉道进行分级。采用描述性统计。
共 54/56 根 3DPG 置钉被评为Ⅰ级（最佳位置），而 49/56 根 FHP 置钉被评为Ⅰ级。2/56 根 3DPG 置钉和 3/56 根 FHP 置钉被评为Ⅱa 级（部分内侧侵犯）。4/56 根 FHP 置钉被评为Ⅲa 级（部分外侧侵犯）。没有钉被评为Ⅱb 级（完全内侧侵犯）。FHP 技术置钉时发生了 6/56 次术中技术偏差，而 3DPG 技术没有。总体而言，3DPG 技术置钉更快（平均±标准差 2.6[1.3] vs. 4.5[1.8] min）。
两种技术均能准确放置脊柱固定钉。3DPG 技术可减少术中偏差和置钉时间。
两种技术均可在犬胸腰椎准确置钉。FHP 技术需要特定的培训和学习曲线，而 3DPG 技术需要特定的软件和 3D 打印机。
