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Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study

The cortical bone trajectory (CBT) screw technique yields effective mechanical and clinical results, improving the holding screw strength with a less invasive exposure. Accurate and safe screw placement is crucial. A patient-specific drill template with a preplanned trajectory was considered a promi...

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Autores principales: Kim, Sang Bum, Rhee, John M., Lee, Gi Soo, Lee, Hee Young, Kim, Taehyung, Won, Yougun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Raven Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250272/
https://www.ncbi.nlm.nih.gov/pubmed/30542224
http://dx.doi.org/10.1097/BTO.0000000000000285
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author Kim, Sang Bum
Rhee, John M.
Lee, Gi Soo
Lee, Hee Young
Kim, Taehyung
Won, Yougun
author_facet Kim, Sang Bum
Rhee, John M.
Lee, Gi Soo
Lee, Hee Young
Kim, Taehyung
Won, Yougun
author_sort Kim, Sang Bum
collection PubMed
description The cortical bone trajectory (CBT) screw technique yields effective mechanical and clinical results, improving the holding screw strength with a less invasive exposure. Accurate and safe screw placement is crucial. A patient-specific drill template with a preplanned trajectory was considered a promising solution; however, it is critical to assess the efficacy and safety of this technique. This study aims to evaluate the accuracy of patient-specific computed tomography (CT)-based rapid prototype drill guide templates for the CBT technique. CT scanning was performed in 7 cadaveric thoracolumbar spines, and a 3-dimensional reconstruction model was generated. By using computer software, we constructed drill templates that fit onto the posterior surface of thoracolumbar vertebrae with drill guides to match the CBT. In total, 80 guide templates from T11 to L5 were created from the computer models by using rapid prototyping. The drill templates were used to guide the drilling of CBT screws without any fluoroscopic control, and CT images were obtained after fixation. The entry point and direction of the planned and inserted screws were measured and compared. In total, 80 screws were inserted from T11 to L5. No misplacement or bony perforation was observed on postoperative CT scan. The patient-specific prototype template system showed the advantage of safe and accurate cortical screw placement in the thoracolumbar spine. This method showed its ability to customize the patient-specific trajectory of the spine, based on the unique morphology of the spine. The potential use of drill templates to place CBT screws is promising.
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spelling pubmed-62502722018-12-10 Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study Kim, Sang Bum Rhee, John M. Lee, Gi Soo Lee, Hee Young Kim, Taehyung Won, Yougun Tech Orthop Novel Research Methods and Models The cortical bone trajectory (CBT) screw technique yields effective mechanical and clinical results, improving the holding screw strength with a less invasive exposure. Accurate and safe screw placement is crucial. A patient-specific drill template with a preplanned trajectory was considered a promising solution; however, it is critical to assess the efficacy and safety of this technique. This study aims to evaluate the accuracy of patient-specific computed tomography (CT)-based rapid prototype drill guide templates for the CBT technique. CT scanning was performed in 7 cadaveric thoracolumbar spines, and a 3-dimensional reconstruction model was generated. By using computer software, we constructed drill templates that fit onto the posterior surface of thoracolumbar vertebrae with drill guides to match the CBT. In total, 80 guide templates from T11 to L5 were created from the computer models by using rapid prototyping. The drill templates were used to guide the drilling of CBT screws without any fluoroscopic control, and CT images were obtained after fixation. The entry point and direction of the planned and inserted screws were measured and compared. In total, 80 screws were inserted from T11 to L5. No misplacement or bony perforation was observed on postoperative CT scan. The patient-specific prototype template system showed the advantage of safe and accurate cortical screw placement in the thoracolumbar spine. This method showed its ability to customize the patient-specific trajectory of the spine, based on the unique morphology of the spine. The potential use of drill templates to place CBT screws is promising. Raven Press 2018-12 2017-12-25 /pmc/articles/PMC6250272/ /pubmed/30542224 http://dx.doi.org/10.1097/BTO.0000000000000285 Text en Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
spellingShingle Novel Research Methods and Models
Kim, Sang Bum
Rhee, John M.
Lee, Gi Soo
Lee, Hee Young
Kim, Taehyung
Won, Yougun
Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title_full Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title_fullStr Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title_full_unstemmed Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title_short Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study
title_sort computer-assisted patient-specific prototype template for thoracolumbar cortical bone trajectory screw placement: a cadaveric study
topic Novel Research Methods and Models
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250272/
https://www.ncbi.nlm.nih.gov/pubmed/30542224
http://dx.doi.org/10.1097/BTO.0000000000000285
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