Application study of three-dimensional printed navigation template between traditional and novel cortical bone trajectory on osteoporosis lumbar spine

Shi, Wenjie; Aierken, Gulixian; Wang, Shuiquan; Abuduwali, Nueraihemaiti; Xia, Yudong; Rezhake, Reyazuli; Zhao, Shuwen; Zhou, Mingbin; Jianabuli,; Sheng, Weibin; Rexiti, Paerhati

doi:10.1016/j.jocn.2020.11.038

Cited by 10 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CBT screw was inserted via the trajectory that could engage the pars, medial, and superior cortices of the pedicle isthmus for spinal fusion, and theoretically, it provided comparable pull-out resistance and stability to a traditional pedicle screw (TPS) (2)(3)(4). Likewise, good results have been found in literature works reporting the application of CBT screw in osteoporosis lumbar spine (1,5,6). The main role of the screw in lumbar fusion is to reduce the motion of the spine and to conduct the stabilization, whereas screw loosening is observed in quite a few literature works (7)(8)(9).…”

Section: Introductionmentioning

confidence: 69%

A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study

Zhang

Li²,

Hai³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

PurposeThis study aims to investigate the risk factors for screw loosening after single-level posterior lumbar interbody fusion (PLIF) utilizing cortical bone trajectory (CBT) screw and establish a nomogram for predicting screw loosening.MethodsA total of 79 patients (316 screws) who underwent single-level PLIF with CBT screw were included in the study. Preoperative, postoperative, and final follow-up demographic data, surgical data, and radiographic parameters were documented and analyzed to identify risk factors, and a predictive nomogram was established for screw loosening. The nomogram was assessed by concordance index (C-index), calibration plot, decision curve analysis (DCA), and internal validation.ResultsThe incidence of screw loosening was 26.6% in 79 patients and 11.4% in 316 screws. Multifactorial regression analysis confirmed that fixed to S1 (FS1, OR = 3.82, 95% CI 1.12–12.71, P = 0.029), the coronal angle of the screw (CA, OR = 1.07, 95% CI 1.01–1.14, P = 0.039), and cortical bone contacted layers (CBCLs, OR = 0.17, 95% CI 0.10–0.29, P < 0.001) were risk factors and incorporated in the nomogram for predicting screw loosening after single-level PLIF with a CBT screw. The C-index of the nomogram was 0.877 (95% CI 0.818–0.936), which demonstrated good predictive accuracy. The calibration plot indicated an acceptable calibration of the nomogram that also had a positive benefit in guiding treatment decisions.ConclusionFS1, CA, and CBCLs are identified to be significant risk factors for screw loosening after single-level PLIF with the CBT technique. The nomogram we have established can be used to predict screw loosening and contribute to surgical decisions.

show abstract

Section: Introductionmentioning

confidence: 69%

A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study

Zhang

Li²,

Hai³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…Modern medicine is becoming more individualized, precise and digital. We can choose CBT or MCBT according to the the exact level or position of the lumbar spine and preoperative imaging data of patients, and even combine the two ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Four intact human wet cadaver lumbar specimens (two males and two females), aged 61–77 years (average: 71 years), were provided by the Anatomy Teaching-Research Office of Xinjiang Medical University ( Figure 1 , 14 ). These specimens were pretreated with 10% (volume fraction) formaldehyde solution, and were confirmed to be free of lumbar fractures, tumors, tuberculosis, and malformation by x-ray.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, 3D printing techniques have been applied in orthopedic clinics ( 14 , 15 ), showing significant advantages in the treatment of spinal diseases and providing an innovative method to improve accuracy in complex spinal surgical operations ( 16 ). We aimed to explore the safety and veracity of 3D printed navigation templates to assist modified CBT (MCBT) screw placement, as well as investigate the auxiliary operating skill and navigation template performance improvement, so as to provide some fundamental basis for further clinical application.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Feasibility and improvement of a three-dimensional printed navigation template for modified cortical bone trajectory screw placement in the lumbar spine

Shi

Aini²,

Dang³

et al. 2022

Front. Surg.

Self Cite

View full text Add to dashboard Cite

ObjectivesCompared with traditional pedicle screw trajectory, cortical bone trajectory (CBT) increases the contact surface between the screw and cortical bone where the screw is surrounded by dense cortical bone, which does not deform remarkably due to degeneration. We aimed to provide detailed information about the improvement of three-dimensional (3D)-printed navigation templates for modified CBT screw placement in the lumbar spine and evaluate the safety and accuracy thereof.MethodsFour human cadaveric lumbar spine specimens were selected. After CT scanning data were reconstructed to 3D models, either the left or right side of each specimen was randomly selected to establish a 3D-navigation template, mutually complemented with the surface anatomical structure of the lateral margin of the lumbar isthmus, vertebral plate, and spinous process. The corresponding 3D centrum was printed according to the CT scanning data, and a navigation template of supporting design was made according to modified cortical bone technique. The same template was used to insert CBT screws into 3D printed and cadaveric specimens. After the screws were inserted, the screw path of the 3D printed specimens was directly observed, and that of the anatomical specimens was scanned by CT, to determine the position and direction of the screws to analyze the success rate of screw placement.ResultsTwenty cortical bone screws were placed in each of the 3D printed and anatomical specimens, with excellent rates of screw placement of 100% and 95%, respectively.ConclusionsWe report the easy, safe, accurate, and reliable use of a 3D-printed navigation template to carry out screw placement by modified cortical bone technique in the lumbar spine.

show abstract

“…Penner et al [38] obtained the comparable with the higher accuracy of CBT reported for the robot-assisted pedicle screw placement using preoperative 3D CT planning. 3D printed navigation template was investigated by our team previously and demonstrated that it improves the accuracy of the MCBT screw placement [39]. Robot-assisted screw placement not only improved its accuracy but also reduced complications [40].…”

Section: Length Of the Screw Pathmentioning

confidence: 99%

Comparison of CT values in traditional trajectory, traditional cortical bone trajectory, and modified cortical bone trajectory

Liu

Kahaer

Wang

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Background: To compare the CT values and length of the screw tracks of traditional trajectory (TT), cortical bone trajectory (CBT), and modified cortical bone trajectory (MCBT) screws and investigate the effects on the biomechanics of lumbar fixation. Methods: CT scan data of 60 L4 and L5 lumbar spine were retrieved and divided into 4 groups (10 male and 10 female cases in the 20-30 years old group and 20 male and 20 female cases in the 30-40 years old group). 3-dimentional (3D) model were established using Mimics 19.0 for each group and the placement of three techniques was simulated on the L4 and L5, and the part of the bone occupied by the screw track was set as the region of interest (ROI). The mean CT value and the actual length of the screw track were measured by Mimics 19.0. Results: The CT values of ROI for the three techniques were significantly different between the same gander in each age group (P＜0.05). The difference of screw track lengths for CBT and MCBT in the male and female is significant (P＜0.05). Conclusions: According to the CT values of the three screw tracks: MCBT > CBT > TT, the MCBT screw track has greater bone-screw surface strength and longer screw tracks than CBT, which is easier to reach the anterior column of the vertebral body contributing to superior biomechanical properties.

show abstract

Application study of three-dimensional printed navigation template between traditional and novel cortical bone trajectory on osteoporosis lumbar spine

Cited by 10 publications

References 27 publications

A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study

A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study

Feasibility and improvement of a three-dimensional printed navigation template for modified cortical bone trajectory screw placement in the lumbar spine

Comparison of CT values in traditional trajectory, traditional cortical bone trajectory, and modified cortical bone trajectory

Contact Info

Product

Resources

About