Abstract
Objective. To perform comparative analysis of safety and accuracy of pedicle screw placement in the cervical and thoracic vertebrae using custom-made 3D-printed navigation templates of various designs. Material and Methods . The study was performed on three cadaver preparations. A total of 60 pedicle screws were placed in C2–T4 using navigation templates of different designs. Three types of templates were used to install 20 screws in each group: monolateral templates in group A, bilateral templates in group B, and bilateral three-point templates supported by the spinous process in group C. The safety and accuracy of screw placement were evaluated by CT with following comparative evaluation. Results. Three-point templates (group C) demonstrated the highest implantation safety, only one screw (5 %) perforated pedicle’s wall with grade 1, 19 screws (95 %) were completely surrounded by bone tissue. In group A, three screws (15%) were placed with grade 1, two screws (10 %) with grade 2, and one screw (5 %) with grade 3. In group B, two screws (10 %) were placed with grade 1, and one screw (5 %) – with grade 2.The average deviation at the screw entry point was 5.0 ± 0.5 mm in group A, 1.7 ± 0.3 mm in group B, and 0.35 ± 0.05 mm in group C. The average deviation at the end point was 5.1 ± 0.7 mm in group A, 3.5 ± 0.6 mm in group B, and 0.53 ± 0.05 mm in group C. Differences between groups in terms of implantation safety and accuracy are statistically significant (p < 0.05). Conclusion. Bilateral three-point navigation templates supported by spinous process are recommended for pedicle screw placement in the cervical and thoracic spine.
Highlights
A total of 60 pedicle screws were placed in C2–T4 using navigation templates of different designs
In group A, three screws (15%) were placed with grade 1, two screws (10 %) with grade 2, and one screw (5 %) with grade 3
Bilateral three-point navigation templates supported by spinous process are recommended for pedicle screw placement in the cervical and thoracic spine
Summary
To perform comparative analysis of safety and accuracy of pedicle screw placement in the cervical and thoracic vertebrae using custom-made 3D-printed navigation templates of various designs. A total of 60 pedicle screws were placed in C2–T4 using navigation templates of different designs. In group B, two screws (10 %) were placed with grade 1, and one screw (5 %) – with grade 2.The average deviation at the screw entry point was 5.0 ± 0.5 mm in group A, 1.7 ± 0.3 mm in group B, and 0.35 ± 0.05 mm in group C. Differences between groups in terms of implantation safety and accuracy are statistically significant (p < 0.05). R.A. Kovalenko et al Design of navigation templates for transpedicular implantation in the cervical and thoracic spine
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