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| WANG Jianhua,XIA Hong,WU Zenghui.Application of digital orthopaedic technique in pediatric upper cervical operation[J].Chinese Journal of Spine and Spinal Cord,2012,(6):516-520. |
| Application of digital orthopaedic technique in pediatric upper cervical operation |
| Received:August 30, 2011 Revised:January 13, 2012 |
| English Keywords:Upper cervical Children Digital orthopaedic tech |
| Fund:上颈椎战创伤的临床救治技术研究（2010gxjs032） |
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| English Abstract: |
| 【Abstract】 Objectives： To investigate the application digital orthopaedic technique in pediatric upper cervical operation. Methods: From March 2009 to March 2011, 7 children suffering from upper cervical disorders underwent posterior instrumentation or transoral anterior reduce plate (TARP) fixation. Among them, there were C1-2 dislocation combined with congenital odontoid malformation in 4 cases, C1-2 tumor complicated with C1-2 dislocation in 1 case, solid C1-2 rotational dislocation in 1 case and basilar invagination complicated with C1-2 dislocation in 1 case. All patients underwent thin slice CT scan before operation, then the DICOM data were put into Mimic and Simpleware software, and after that the three dimentional model of upper cervical as well as individual navigation template were produced, which were used for imitating operation and screw implantation. Anterior approach was performed in 4 cases, posterior approach in 2 cases, and combined anterior and posterior approach in 1 case. After operation, CT -scan was used to evaluate the screw path, and the neurofunction was evaluated by JOA score. Results: All 7 patients got a successful operation. The mean operation time was 3-6 hours(average, 3.5±0.6 hours). The blood loss was 300-400ml. Posterior instrumentation was performed in 5 cases and TARP in 2 cases, which included 10 atlas pedicle screws, 10 axis pedicle screws, 2 anterior atlas mass screws, 2 occipital condyle screws, 2 anterior axis retro-pedicle screws, and 2 axis vertebral body screws. Postoperative CT scan showed good position of all screws, without penertration into vertebral cannal or vertebral artery groove. All 7 patients had limb numbness and weakness improved significantly, with the JOA score increasing from 8.6±1.5 to 15±1.8(P<0.05). Conclusions: Digital orthopaedic technique can ensure the safety and lower surgical risk, which is applicable to pediatric upper cervical surgery. |
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