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| CHEN Yubing,LU Sheng,XU Yongqing.Primary clinical application of patient-specific navigational template for the thoracic pedicle screw placement[J].Chinese Journal of Spine and Spinal Cord,2011,(8):669-674. |
| Primary clinical application of patient-specific navigational template for the thoracic pedicle screw placement |
| Received:January 18, 2011 Revised:April 18, 2011 |
| English Keywords:Internal fixation Pedicle screws Thoracic spine Patient-specific navigational template Computer aided design Rapid prototyping |
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| English Abstract: |
| 【Abstract】 Objective：To evaluate the accuracy and safty of thoracic transpedicular screw placement by patient-specific navigational template.Method：From July 2008 to September 2009，46 patient-specific navigational templates were designed and established before operation on the basis of 3D reconstruction of computed tomography image.A total of 11 patients（including 7 adolescent idiopathic scoliosis，2 congenital scoliosis，1 thoracic spine tuberculosis and kyphosis，and 1 multiple thoracic vertebral fracture） underwent spinal deformity correction. Subsequently，92 screws were placed from T2 to T12 in 11 cases by the patient-specific template technique. After surgery，the positions of the pedicle screws were evaluated using CT scan and graded for validation.The complications related to screw placement were recorded.Result：83 of the 92 screws located in the pedicle，while 9 screws were noted to break the pedicle（2 medially and 7 laterally）.Parapedicle screw fixation was performed due to pedicle diameter less than 4mm（from 3.0mm to 3.8mm） in 5 screws.No pedicle screw perforation of more than 2mm was noted.The unintended perforation rate was 4.3%.The accurate rate of thoracic pedicle screw placement was 95.7%，and overall screw acceptable ratio（<2mm breach is safe） was 100%.No screws penetrated the inferior or superior cortex of pedicle in the sagittal plane.No neurovascular and visceral injury related-complications was noted.Conclusion：Thoracic transpedicular screw placement assisted by patient-specific navigational template is safe and reliable. |
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