World Neurosurg. 2022 Mar 5:S1878-8750(22)00273-X. doi: 10.1016/j.wneu.2022.02.126. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate the accuracy of using patient-specific drill guides to place bilateral laminar screws in C1 and C2.
METHODS: Nine cervical specimens (8 male; mean age: 66.6 (56-73)) with the occiput attached (C0-C3) were used in this study. Pre-operative CT scans were used to create digital anatomic models for templating and guide creation. A total of 36 screws were placed with the aid of 3D printed patient-specific guides (2 screws at C1 and C2). Post-operative CT scans were performed following screw insertion. The planned and actual trajectories were compared using pre- and post-operative imaging based on the angular and entry point deviation. After screw placement and post-operative imaging, each specimen was dissected and performed a visual inspection for breaches.
RESULTS: No breaches or violations were observed on post-procedure CT and visual inspection. The average variation of the entry point in the X, Y, and Z-axis was 0.3±0.28, 0.41±0.38, and 0.29±0.24, respectively. No statistically significant difference (p>0.05) was observed between the planned and obtained entry points. There was no significant difference (p>0.05) in the deviation analysis between the planned and obtained angles in the axial and coronal planes.
CONCLUSION: The study demonstrates that patient-specific drill guides allow for accurate C1 and C2 bilateral laminar screw placement, with a low risk of cortical breach.
PMID:35259502 | DOI:10.1016/j.wneu.2022.02.126
