A multi-level rapid prototyping drill guide template reduces the perforation risk of pedicle screw placement in the lumbar and sacral spine

Merc, Matjaž; Drstvenšek, Igor; Vogrin, Matjaž; Brajlih, Tomaž; Rečnik, Gregor

doi:10.1007/s00402-013-1755-0

Cited by 94 publications

(63 citation statements)

References 15 publications

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“…Patient-specific instrument (PSI) has been reported as an alternative intraoperative assistance to computer navigation. PSI is applied to joint arthroplasty, [8,9] spinal pedicle screws insertion [10,11] and deformity correction. [12,13] PSI has recently been investigated in bone tumor surgery.…”

Section: Introductionmentioning

confidence: 99%

One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection

Kumta

et al. 2015

Computer Aided Surgery

206

146

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Resection of a pelvic tumor is challenging because of its complex three-dimensional (3D) anatomy and deep-seated location with nearby vital structures. The resection is technically demanding if a custom implant is used for reconstruction of the bone defect as the surgeon needs to ensure the resection margin is sufficiently wide and the orientation of intended resection planes must match that of the custom implant. We describe a novel workflow of performing a partial acetabular resection in a patient with pelvic chondrosarcoma and reconstruction with a custom pelvic implant in a one-step operation. A multi-planar bone resection was virtually planned. A computer-aided design implant that both matched the bone defect and biomechanically evaluated was prefabricated with 3D printing technology. The 3D-printed patient-specific instruments (PSIs) were used to reproduce the same planned resection. The histology of the tumor specimen showed a clear resection margin. The errors of the achieved resection and implant position were deviating (1-4 mm) from the planned. The patient could walk unaided with a good hip function. No tumor recurrence and implant loosening were noted at 11 months after surgery. The use of this novel CTbased method for surgical planning, the engineering software for implant design and validation, together with 3D printing technology for implant and PSI fabrication makes it possible to generate a personalized, biomechanically evaluated implant for accurate reconstruction after a pelvic tumor resection in a one-step operation. Further study in a larger population is needed to assess the clinical efficacy of the workflow in complex bone tumor surgery. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection

Kumta

et al. 2015

Computer Aided Surgery

206

146

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“…RP technology is widely used in the field of orthopedics, and may quickly transform digital design into a physical entity. In recent times, a number of spinal screw guides have been produced using RP technology [10][11][12]. However, to our knowledge and understanding, only a few have achieved desired effects.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge and understanding, only a few have achieved desired effects. It has been reported that 26% of all pedicle screws were inserted inaccurately, with the length of 14% of screws too dissimilar in design for successful use of the multi segmental lumbosacral screw guide designed by Merc [10]. In this study, we used RP technology to make our own TFS guide.…”

Section: Discussionmentioning

confidence: 99%

Translaminar facet joint screw insertion with a rapid prototyping guide template: a cadaver study

Cao

Zhang

Liang

et al. 2019

Computer Assisted Surgery

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“…For example, zygoma implants are used for functional reconstruction of maxillary defects [4], iliosacral screw insertions are utilized for treating pelvic fractures [5], and pedicle screw placement is adopted for spine surgery [6]. However, intraoperative drilling performance still poses a significant challenge for surgeon due to anatomic intricacies in the surgical region.…”

Section: Introductionmentioning

confidence: 99%

Development of a surgical navigation system based on 3D Slicer for intraoperative implant placement surgery

Chen

Wang

et al. 2017

Medical Engineering & Physics

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Implant placement has been widely used in various kinds of surgery. However, accurate intraoperative drilling performance is essential to avoid injury to adjacent structures. Although some commercially-available surgical navigation systems have been approved for clinical applications, these systems are expensive and the source code is not available to researchers. 3D Slicer is a free, open source software platform for the research community of computer-aided surgery. In this study, a loadable module based on Slicer has been developed and validated to support surgical navigation. This research module allows reliable calibration of the surgical drill, point-based registration and surface matching registration, so that the position and orientation of the surgical drill can be tracked and displayed on the computer screen in real time, aiming at reducing risks. In accuracy verification experiments, the mean target registration error (TRE) for point-based and surface-based registration were 0.31±0.06mm and 1.01±0.06mm respectively, which should meet clinical requirements. Both phantom and cadaver experiments demonstrated the feasibility of our surgical navigation software module.

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A multi-level rapid prototyping drill guide template reduces the perforation risk of pedicle screw placement in the lumbar and sacral spine

Cited by 94 publications

References 15 publications

One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection

One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection

Translaminar facet joint screw insertion with a rapid prototyping guide template: a cadaver study

Development of a surgical navigation system based on 3D Slicer for intraoperative implant placement surgery

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