Yang Li1, Jing Lin2,3, Yuan Wang4, Haotian Luo1, Jing Wang1, Sheng Lu1, Yongqing Xu5. 1. Department of Orthopedics, The 920th Hospital of Joint Logistic Support Force of PLA, Kunming, 650032, China. 2. Department of Neurosurgery, The 452 Hospital of Western Air Force, Chengdu, 610021, China. 3. Department of Health Statistics, Second Military Medical University, Shanghai, 200003, China. 4. Second Department of Spine Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, 20003, China. 5. Department of Orthopedics, The 920th Hospital of Joint Logistic Support Force of PLA, Kunming, 650032, China. xuyongqingkm@163.net.
Abstract
OBJECTIVE: The objective of the study was to compare the safety, efficacy, and accuracy of the pedicle screws with the three-dimensional (3D) printed navigation template to the free-hand screws for type II odontoid fractures. PATIENTS AND METHODS: A total of 60 patients with type II odontoid fractures, treated with either template guiding pedicle screws or free-hand screws, were retrospectively assessed. The guiding group was treated with pedicle screws with the assistance of a virtual reality (VR) software-designed, 3D printed navigation template with two guide tubes. The safety rate and treatment efficacy of the screw placement, as well as the trajectory accuracy, were evaluated by respective measures and compared between two surgical groups. RESULTS: There were reduced surgical time (P < 0.05), blood loss (P < 0.01), and C-arm shots (P < 0.01) with 3D printed template guiding screws. The rates of safe pedicle screws in both C1 and C2 were significantly higher in 3D guiding group (P < 0.01) compared to the free-hand group, and the scores of visual analogue scale (VAS) and impairment scale (ASIA) were improved in guiding group at 1 week post-surgery (P < 0.01 and P < 0.05, respectively). Postoperative CT and image reconstruction showed the 3D guiding group had better horizontal screw accuracy on both sides of C1 (L: P < 0.001, R: P < 0.01) and C2 (L: P < 0.001, R: P < 0.01) than free-hand group. CONCLUSION: The herein screw technique using 3D printed navigation template leads to greater improvement in the screw safety, efficacy, and accuracy, which may be a promising alternative to free-hand surgery for the treatment of odontoid fractures.
OBJECTIVE: The objective of the study was to compare the safety, efficacy, and accuracy of the pedicle screws with the three-dimensional (3D) printed navigation template to the free-hand screws for type II odontoid fractures. PATIENTS AND METHODS: A total of 60 patients with type II odontoid fractures, treated with either template guiding pedicle screws or free-hand screws, were retrospectively assessed. The guiding group was treated with pedicle screws with the assistance of a virtual reality (VR) software-designed, 3D printed navigation template with two guide tubes. The safety rate and treatment efficacy of the screw placement, as well as the trajectory accuracy, were evaluated by respective measures and compared between two surgical groups. RESULTS: There were reduced surgical time (P < 0.05), blood loss (P < 0.01), and C-arm shots (P < 0.01) with 3D printed template guiding screws. The rates of safe pedicle screws in both C1 and C2 were significantly higher in 3D guiding group (P < 0.01) compared to the free-hand group, and the scores of visual analogue scale (VAS) and impairment scale (ASIA) were improved in guiding group at 1 week post-surgery (P < 0.01 and P < 0.05, respectively). Postoperative CT and image reconstruction showed the 3D guiding group had better horizontal screw accuracy on both sides of C1 (L: P < 0.001, R: P < 0.01) and C2 (L: P < 0.001, R: P < 0.01) than free-hand group. CONCLUSION: The herein screw technique using 3D printed navigation template leads to greater improvement in the screw safety, efficacy, and accuracy, which may be a promising alternative to free-hand surgery for the treatment of odontoid fractures.
Authors: Shao-Jie Zhang; Kun Li; Zhi-Jun Li; Xing Wang; Jia-Hui Dong; Jian Wang; Jie Chen; Xing-Yue Qu; Zi-Yu Li; Yu-Hang Liu Journal: Int J Gen Med Date: 2021-09-16
Authors: Peter Endre Eltes; Marton Bartos; Benjamin Hajnal; Agoston Jakab Pokorni; Laszlo Kiss; Damien Lacroix; Peter Pal Varga; Aron Lazary Journal: Front Surg Date: 2021-01-25