A Novel Drill Navigation Template Combines Preoperative Simulation in Expansive Open-Door Laminoplasty

Zhang, Xiuru; Zhang, Yongfei; Duan, Desheng; Xie, Huiqi

doi:10.1016/j.wneu.2018.07.041

Cited by 6 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the thermal effect, the application of high‐speed micro‐drills can stop excessive blood loss due to a localized increase of temperature during the surgery 20 . However, our study detected that there was no statistical difference in terms of intra‐operative blood loss between the groups.…”

Section: Discussioncontrasting

confidence: 59%

“…The Designed Sharp Rongeur Enhances more Satisfactory Radiological and Clinical Outcomes for FDL, Compared to the Traditional High-Speed Micro-Drill Considering the thermal effect, the application of high-speed micro-drills can stop excessive blood loss due to a localized increase of temperature during the surgery. 20 However, our study detected that there was no statistical difference in terms of intra-operative blood loss between the groups. As concerned, skilled operators and tamping hemostatic materials can effectively reduce the intra-operative bleeding using this sharp rongeur.…”

Section: Discussioncontrasting

confidence: 54%

See 1 more Smart Citation

A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty

Chen

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective:Although the lamina open angle of making hinges is closely related to the outcomes of French-door laminoplasty (FDL) for treatment of cervical spondylosis, there have been no methods to predict the lamina open angle preoperatively as yet. The aim of this study was to investigate the accuracy of predicting the laminal open angle using our newly designed sharp rongeur, and to compare the postoperative outcomes and complications between the methods of making hinges using the newly designed sharp rongeur and the traditional high-speed micro-drill during the FDL.Methods: This was a single-center retrospective study. Following the approval of the institutional ethics committee, a total of 39 patients (Male: 28; Female: 11) diagnosed with cervical spondylos who underwent FDL in our institution between January 2018 and May 2019 were enrolled. Patients were divided into two groups based on the method of making hinges (sharp rongeur: 22 cases; high-speed micro-drill: 17 cases). The average age at surgery was 59.1 years (range: 16-85 years). The radiological parameters, clinical outcomes, modified Japanese Orthopaedic Association (mJOA) scale score, and the recovery rate of mJOA were recorded and compared between the groups, respectively. The radiological parameters and clinical measurements at pre-and post-operation stages were compared using the paired-sample t-test, the Wilcoxon signed-rank test, and the Friedman's test, and variables in the two groups were analyzed using an unpaired Student's t-test or a Mann-Whitney U test. Results:The average follow-up period was 20.4 months (range: 14.0-25.9 months), the postoperative open angle was 60.13 AE 3.69 in the rongeur group with 22.78 AE 4.34 of angular enlargement, which was significantly lower than that of 68.96 AE 1.00 in the micro-drill group with 32.75 AE 4.22 of angular enlargement (U = 19.000, p < 0.001). The rongeur group showed a higher fusion rate (34.1% vs 14.7%, χ 2 = 11.340, p = 0.001), and a lower fracture rate of the lamina (7.8% vs 25.5%, χ 2 = 14.185, p < 0.001) at 1-month post-surgery, compared to the microdrill group. There were no significant differences in the clinical outcomes and postoperative complications between the two groups (p > 0.05), except in the recovery rate of mJOA scores (0.836 AE 0.138 vs 0.724 AE 0.180, U = 115.000, p = 0.042) and neck disability index (NDI) at the final follow-up (7.55 AE 10.65 vs 14.71 AE 8.72, U = 94.000, p = 0.008). Conclusions:The special sharp rongeur with a tip angle of 20 could be a preferred method to make hinges during FDL, which can predict the laminal open angle accurately and enlarge it to about 23 , thus reducing the fracture rate and accelerating the bony fusion of hinges compared with the outcomes of the traditional micro-drill method.

show abstract

Section: Discussioncontrasting

confidence: 59%

Section: Discussioncontrasting

confidence: 54%

A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty

Chen

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…In the literature, this ratio has generally been compared before and after the operation. In the study performed by Zhang et al, in which cervical laminoplasty methods were compared surgically, no significant difference was found between post-operative Pavlov rates (15). Pavlov ratio was found to be an independent risk factor for blood loss in the study of Meng et al, where they investigated the risk factors associated with blood loss during cervical laminoplasty (16).…”

Section: Discussionmentioning

confidence: 96%

Open-door servikal laminoplasti tekniğine bağlı hinge fraktürü (menteşe kırığı) komplikasyonu gelişmesini etkileyen risk faktörlerinin değerlendirilmesi

Gürkan

Kaya

Atar³

et al. 2021

Ege Tıp Dergisi

View full text Add to dashboard Cite

Aim: Open-door cervical laminoplasty is the standard surgical option for patients with multipl levels cervical myelopathy. In this surgical technique, while linear laminectomy is performed on one side of the lamina, bone is drilled to form a hinge on the opposite side. Hinge fractures may occur on the other side while lifting the linear laminectomy side. Our study aimed to examine possible risk factors for preventing these fractures. Materials and Methods: The patients' files, radiological images, and laboratory results who underwent cervical laminoplasty between 2013-2018 were retrospectively analyzed. Results: A total of 78 patients, 54 males and 24 females, were included in the study. The mean age of the patients was 57.8±11.6 years. The mean modified Japanese Orthopedic Association (JOA) cervical myelopathy scores of the patients before the operation were 16.2±2.1. When the preoperative blood Ca values were examined, the mean value was 9.3±0.5 mg/dl. The mean Pavlov ratio of the patients was 0.7±0.2. Laminas were opened from the right side in 26 cases and from the left side in 52 cases. A total of 304 laminae were opened. In post-operative control cervical CTs, 42 patients had lamina hinge fractures, and the number of patients without hinge fracture was 36. There were 89 fractures in total at the lamina level. When post-operative cervical tomography images were examined, the mean opening angle (OA) of the laminas was 30.6±8.9 degrees. The opening angle of the lamina was determined to affect the hinge fracture significantly. While OA was 32.3±9 degrees in patients with lamina hinge fracture, it was found to be 28.7±8.3 in patients without fractures (p <0.05). Conclusion:During open-door cervical laminoplasty, the excessive opening angle of the lamina increases the possibility of hinge fractures. Pre-operative necessary measurements will reduce the risk of hinge fractures during surgery. This evaluation will reduce the risk of complications during the operation and increase patient comfort in the post-operative period.

show abstract

Automatic Pavlov ratio measurement method based on spinal landmarks identification by a deep‐learning model

Wang,

Huang,

Zhou

et al. 2024

Medical Physics

View full text Add to dashboard Cite

BackgroundCervical canal stenosis is one of the important pathogenic factors of cervical spondylosis. The accuracy of the Pavlov ratio measurement is crucial for the diagnosis and treatment of cervical spinal stenosis. Manual measurement is influenced by observer variability, accompanied by its inefficiency, which affects clinical evaluation.PurposeTo automatically and accurately measure the Pavlov ratio, we develop a novel deep‐learning model by detecting keypoints of cervical spine and measure the Pavlov ratio on plain lateral cervical spine radiographs.MethodsWe developed a two‐stage deep‐learning model; in the first stage, we employ the YOLOX model as the object detection network to locate the ROIs containing the vertebral bodies and spinous processes; in the second stage, we introduce the high‐resolution net (HRNet) as keypoint detection network and a series of deconvolutional networks (DNs) as the heatmap‐based regressor. Based on the mentioned combining algorithms, we can rapidly detect the 38 keypoints in plain lateral cervical spine radiographs, and then measure the Pavlov ratio of the cervical spine. Radiographs from Shanghai Changhai Hospital (a total of 874) were split into training and test subsets (787 and 87 radiographs, respectively). One hundred twelve cases from Shanghai Changzheng Hospital and 108 cases from Shanghai Fourth People's Hospital are used as external validation datasets.ResultsOur proposed model successfully achieved the objective of automating the recognition of spinal landmarks with the mean absolute error (MAE)ranged from 0.05 to 0.08, and the symmetric mean absolute percentage error (SMAPE) ranged from 4.54% to 6.43%. The achieved accuracy is comparable to that of seasoned medical professionals and notably surpasses the performance of junior physicians (SMAPE ranged from 8.74% to 26.19%). Furthermore, our model demonstrated excellent accuracy in external validation experiments (SMAPE ranged from 4.40% to 5.95%).ConclusionThis study presents a novel YOLOX‐HRNet‐DN model to assist landmarks identification on lateral cervical spine radiographs and demonstrates excellent accuracy in measuring the Pavlov ratio. The proposed method could provide a potential tool for the automatic estimation of the Pavlov ratio to improve the efficiency and accuracy of the treatment workflow.

show abstract

A Novel Drill Navigation Template Combines Preoperative Simulation in Expansive Open-Door Laminoplasty

Cited by 6 publications

References 31 publications

A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty

A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty

Open-door servikal laminoplasti tekniğine bağlı hinge fraktürü (menteşe kırığı) komplikasyonu gelişmesini etkileyen risk faktörlerinin değerlendirilmesi

Automatic Pavlov ratio measurement method based on spinal landmarks identification by a deep‐learning model

Contact Info

Product

Resources

About