Three-Dimensional Computed Tomography-Based, Personalized Drill Guide for Posterior Cervical Stabilization at C1–C2

Goffin, Jan; Brussel, Karel Van; Martens, K.; Sloten, Jos Vander; Audekercke, Remy Van; Smet, Maria-Helena

doi:10.1097/00007632-200106150-00017

Cited by 88 publications

(54 citation statements)

References 15 publications

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“…As such, if one side is shown on preoperative CT or MRI scans to be of an inadequate shape, instrumentation of just one side may still represent an acceptable solution. Newer technologies involving computer assistance [29] or other intraoperative assistive devices [14,24] will surely be useful for preoperative planning and safer screw placement. The absence of severe complications due to screw placement on one side only, and the generally good clinical outcome in the group as a whole, appears to support the use of transarticular screw fixation in atlantoaxial osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

Transarticular screw fixation for osteoarthritis of the atlanto axial segment

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Transarticular screw fixation for osteoarthritis of the atlanto axial segment

et al. 2005

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“…Individual templates can BI basilar invagination, C0-2 posterior occipital-C2 fixation, OA occipitalization of the atlas, C2-3 C2-3 vertebral fusion a Unilateral laminar screw fixation and other side of pedicle screw fixation be produced at a reasonable price compared with the cost of intraoperative navigation systems. In the past decade, drill templates were initially demonstrated in the hip and knee [23], but several studies have described their use in the cervical, thoracic, and lumbar spine [1,6,17]. Some authors have designed different individual templates for spinal pedicle screw placement.…”

Section: Discussionmentioning

confidence: 99%

“…An advantage of using this design is that excessive soft-tissue dissection from the vertebra is not necessary. Goffin et al [6] designed a template that featured a number of clamps to interface with the posterior course of the cervical vertebra. More recently, Owen et al [22] constructed a drill template that was designed to match the posterior surface of the cervical vertebra around the entry point.…”

Section: Discussionmentioning

confidence: 99%

A novel computer-assisted drill guide template for placement of C2 laminar screws

Zhang

et al. 2009

Eur Spine J

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The present method of C2 laminar screw placement relies on anatomical landmarks for screw placement. Placement of C2 laminar screws using drill template has not been described in the literature. The authors reported on their experience with placement of C2 laminar screws using a novel computer-assisted drill guide template in nine patients undergoing posterior occipitocervical fusion. CT scan of C2 vertebrae was performed. 3D model of C2 vertebrae was reconstructed by software MIMICS 10.01. The 3D vertebral model was then exported in STL format, and opened in a workstation running software UG imageware12.0 for determining the optimal laminar screw size and orientation. A virtual navigational template was established according to the laminar anatomic trait. The physical vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intraoperative to assist the placement of laminar screw. Overall, 19 C2 laminar screws were placed and the accuracy of screw placement was confirmed with postoperative X-ray and CT scanning. There were not complications of related screws insertion. Average follow-up was 9 months (range 4-13 months), 77.8% of the patients exhibited improvement in their myelopathic symptoms; in 22.2% the symptoms were unchanged. Postoperative computed tomographic (CT) scanning was available for allowing the evaluation of placement of thirteen C2 laminar screws, all of which were in good position with no spinal canal violation. This study shows a patient-specific template technique that is easy to use, can simplify the surgical act and generates highly accurate C2 laminar screw placement. Advantages of this technology over traditional techniques include planning of the screw trajectory is done completely in the presurgical period as well as the ability to size the screw to the patient's anatomy.

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“…The first approach is to consider the shape of the guide as a negative of the vertebra bone surface [12][13][14]. The second approach uses supports affixed to the transverse process, the spinous process, and/or the lamina [15][16][17][18]. Regarding the preoperative definition of the ideal screw direction, most of the studies are based on the prior identification by the surgeon [19,20] and in a few works [21][22][23][24][25] the authors determine a predefined best pedicle screw trajectory and/or diameter and maximum screw length.…”

Section: Introductionmentioning

confidence: 99%

Novel Procedure for Designing and 3D Printing a Customized Surgical Template for Arthrodesis Surgery on the Sacrum

Naddeo

Cappetti

et al. 2018

Symmetry

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Abstract:In this article, the authors propose a novel procedure for designing a customized 3D-printed surgical template to guide surgeons in inserting screws into the sacral zone during arthrodesis surgeries. The template is characterized by two cylindrical guides defined by means of trajectories identified, based on standard procedure, via an appropriate Computer-Aided-Design (CAD)-based procedure. The procedure is based on the definition of the insertion direction by means of anatomical landmarks that enable the screws to take advantage of the maximum available bone path. After 3D printing, the template adheres perfectly to the bone surface, showing univocal positioning by exploiting the foramina of the sacrum, great maneuverability due to the presence of an ergonomic handle, as well as a break system for the two independent guides. These features make the product innovative. Thanks to its small size and the easy anchoring, the surgeon can simply position the template on the insertion area and directly insert the screws, without alterations to standard surgical procedures. This has the effect of reducing the overall duration of the surgery and the patient's exposure to X-rays, and increasing both the safety of the intervention and the quality of the results.

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Three-Dimensional Computed Tomography-Based, Personalized Drill Guide for Posterior Cervical Stabilization at C1–C2

Abstract: Although the actual experience is limited, the idea of using a template with drill guide might simplify and shorten the surgical act and at the same time enhance the accuracy of C1-C2 transarticular screw positioning.

Cited by 88 publications

References 15 publications

Transarticular screw fixation for osteoarthritis of the atlanto axial segment

Transarticular screw fixation for osteoarthritis of the atlanto axial segment

A novel computer-assisted drill guide template for placement of C2 laminar screws

Novel Procedure for Designing and 3D Printing a Customized Surgical Template for Arthrodesis Surgery on the Sacrum

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