A Novel Procedure to Design a Positionable and Stable Drilling Template for Spine Surgery

Abstract

Spine surgery is based, nowadays, on the use of cutting-edge instruments that optimize the intervention processes in the operating room, with advantages that affect the patient himself. Among these, rapid prototyping is configured as a first-rate tool, thanks to its ability to detail the diagnostic treatment according to the specific pathological case under examination. An example of this technology is represented by the generation of a drilling template, to assist the surgeon in identifying the optimal direction of insertion of the pedicle screws, capable of significantly reduce intervention times, in addition to the inevitable exposure of the patient to ionizing radiation, to which he is subjected during a normal arthrodesis intervention procedure. The design of a drilling guide requires, however, a particular attention in identifying the undercuts present on the vertebral surface, those areas of the spinous process which, reported inside the cavity of the template, involve complications at the time of extraction. In parallel, it is vitally important to carry out an evaluation of its stability during its use. In this article, starting from the analysis of the interferences present during the insertion of the template, a semi-automatic correction model is proposed for the generation of a new profile of the same, which facilitates its extraction without causing injury to the vertebral regions involved from the contact with the mask.