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Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model

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Image-based drill templates for cervical pedicle screw placement.

Timothy C Ryken¹, Brent D Owen, Gary E Christensen

¹Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA. timothy-ryken@uiowa.edu

Journal of Neurosurgery. Spine

|January 6, 2009

Summary

Patient-specific drill templates show promise for accurate cervical pedicle screw placement. This technique demonstrated high accuracy in cadaveric studies, minimizing cortical violations for improved spinal fixation.

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Spinal Anatomy

Background:

Cervical pedicle screws (PSs) offer superior fixation but are challenging to place due to small vertebral anatomy.
Current methods for cervical PS placement have limitations in accuracy and safety.

Purpose of the Study:

To evaluate the accuracy of patient-specific, rapid prototype drill templates for cervical pedicle screw placement.
To assess the feasibility of using 3D-printed templates for guiding screw trajectories in the cervical spine.

Main Methods:

Cadaveric cervical spines (C3-7) underwent CT scanning.
Patient-specific drill templates were designed using software and fabricated via rapid prototyping.
Templates guided pilot-hole drilling; accuracy was assessed by CT and direct visual inspection after screw placement.

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Main Results:

The patient-specific drill template technique was feasible and demonstrated high accuracy.
Ninety-five percent (19/20) of pilot holes and screws showed no critical pedicle cortex violation.
The single observed violation was deemed noncritical.

Conclusions:

Rapid prototype drill templates are a promising tool for accurate cervical pedicle screw placement.
This method offers a potentially safer and more precise trajectory for spinal instrumentation.