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Deviation analysis for C1/2 pedicle screw placement using a three-dimensional printed drilling guide.

Xinghuo Wu1, Rong Liu2, Jie Yu3

  • 11 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
|January 7, 2017
PubMed
Summary

A novel 3D-printed drilling guide enhances safety and accuracy for C1/2 pedicle screw placement in cervical spine surgery. This technique offers a promising, easy, and safe method for complex cervical fixation procedures.

Keywords:
Pedicle screwguideplacementprintthree-dimensional

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Neurosurgery

Background:

  • Cervical transarticular fixation is a complex surgical procedure.
  • Accurate C1/2 pedicle screw placement is crucial for successful outcomes.
  • Existing methods pose technical challenges and risks.

Purpose of the Study:

  • To develop and evaluate a novel 3D-printed drilling guide for C1/2 pedicle screw placement.
  • To improve the safety and accuracy of this technically demanding procedure.
  • To assess the feasibility of using 3D printing for enhanced cervical fixation.

Main Methods:

  • Utilized computed tomography (CT) scans from 20 patients with C1/2 fractures/dislocations.
  • Developed patient-specific 3D-printed drilling guides for C1/2 pedicle screw insertion.
  • Placed bilateral C1/2 pedicle screws in 3D models using the guides.
  • Evaluated screw placement accuracy and safety using sagittal and axial CT scans (X-Y-Z axis analysis).

Main Results:

  • Successful placement of bilateral C1/2 pedicle screws in 3D models with the guide.
  • Average screw depths measured: C1 (L: 30.1±1.12mm, R: 29.54±1.01mm), C2 (L: 31.81±0.85mm, R: 31.35±0.27mm).
  • No statistically significant differences found between ideal and actual screw entry points, inclined, and tailed angles.

Conclusions:

  • The 3D-printed drilling guide method is an easy and safe technique.
  • This novel approach is applicable and promising for C1/2 pedicle screw fixation.
  • 3D printing offers a valuable tool for improving precision in cervical spine surgery.