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An Intraoperative Trajectory-Determined Strategy of Patient-Specific Drill Template for C2 Transoral Pedicle Insertion in Incomplete Reduction of Atlantoaxial Dislocation: An In Vitro Study.

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收录情况： ◇ SCIE

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机构： [1]Department of Orthopaedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang, [2]Department of Joint and Orthopaedics, Zhujiang Hospital,Southern Medical University Southern Medical University [3]Department of Orthopaedics, TCMIntegrated Hospital of Southern Medical University, Guangzhou [4]Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University [5]Nanhai Hospital, Southern Medical University, Foshan, China

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关键词： Atlantoaxial joint Pedicle screw 3D printing Cadaver Classification

摘要：

This study aims to explore a novel intraoperative trajectory-determined strategy of grouped patient-specific drill templates (PDTs) for transoral C2 pedicle screw insertion (C2 TOPI) for atlantoaxial dislocation (AAD) with incomplete reduction and to evaluate its efficiency and accuracy.Ten cadaveric C2 specimens were scanned by computed tomography (CT) and randomly divided into two groups (the PDT and freehand groups). A novel intraoperative trajectory-determined strategy of grouped PDTs was created for AAD with incomplete reduction. C2 TOPI was performed by use of the PDT technique and the fluoroscopy-guided freehand technique. After surgery, the screw deviations from the centroid of the cross-section at the midpoint of the pedicle and screw position grades were assessed in both groups.Compared to the freehand group, the PDT group had a significantly shorter surgery time than the freehand group (47.7 vs 61.9 min, P < 0.001). The absolute deviations from the centroids between the preoperative designs and postoperative measurements on the axial plane of the pedicle were 1.19 ± 0.25 mm in the PDT group and 1.82 ± 0.51 mm in the freehand group. On the sagittal plane of the pedicle, the corresponding values were 1.10 ± 0.33 mm in the PDT group and 1.70 ± 0.49 mm in the freehand group. The absolute deviations of the free-hand group on both the axial and sagittal planes were higher than that of the freehand group (P < 0.05 and P < 0.05, respectively). For the grade of screw insertion position, nine (90%) were observed in type I and one (10%) in type II in the PDT group, whereas five (50%) were in type I, three (30%) were in type II, and two (20%) in type III in the freehand group. Statistical differences could not be found between the groups in terms of the screw positions (P > 0.05).The novel intraoperative trajectory-determined strategy of grouped PDTs can be used as an accurate and feasible method for C2 TOPI for AAD with incomplete reduction.© 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

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出版当年[2020]版：

大类 | 2 区医学

小类 | 2 区骨科

最新[2025]版：

大类 | 4 区医学

小类 | 4 区骨科

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出版当年[2019]版：

Q3 ORTHOPEDICS

最新[2023]版：

Q2 ORTHOPEDICS

影响因子： 1.8 最新[2023版] 2.4 最新五年平均 1.718 出版当年[2019版] 1.666 出版当年五年平均 1.331 出版前一年[2018版] 2.071 出版后一年[2020版]

第一作者：

第一作者机构： [1]Department of Orthopaedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang,

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通讯作者：

通讯机构： [1]Department of Orthopaedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang, [2]Department of Joint and Orthopaedics, Zhujiang Hospital,Southern Medical University Southern Medical University [4]Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University [5]Nanhai Hospital, Southern Medical University, Foshan, China [*1]Department of Orthopaedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, 17 yongwaizheng street, Donghu District, Nanchang, Jiangxi, China 330006 [*2]Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, 253 Gongye Street, Haizhu District, Guangzhou, Guangdong, China 510280 [*3]Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, 1023 Shatai Nan Road, Baiyun District, Guangzhou, Guangdong, China [*4]Nanhai Hospital, Southern Medical University, 28 Liguan Road, Lishui Town, Nanhai District, Foshan, Guangdong, China 510515

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An Intraoperative Trajectory-Determined Strategy of Patient-Specific Drill Template for C2 Transoral Pedicle Insertion in Incomplete Reduction of Atlantoaxial Dislocation: An In Vitro Study.

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