Surgical application of pedicle drill template navigation technology for complicated scoliosis

Abstract

To evaluate the surgical efficacy and significance of pedicle drill template navigation technology for severe complicated scoliosis. Retrospective analyses were performed for 8 patients with complicated spinal scoliosis during 2010-2013. There were 5 males and 3 females with an average age of 18 (9-23) years. There were congenital (n = 5) and idiopathic (n = 3) scoliosis. A three-dimensional spinal computed tomography (CT) scan was performed. And the data were acquired and transferred via a DICOM network to a computer workstation. Three-dimensional reconstruction and rapid prototype were obtained. The navigation drill template was manufactured by rapid prototyping for clinical operation. Eight matched patients without navigation drill template were selected into a control group. Eight patients were successfully operated as planned without any complication of spinal cord, nerve or blood vessel injury. And their post-operative outcomes were satisfactory. The intra-operative findings were the same as pre-operative impressions and measurements by digital spinal three dimensional reconstructions. The results of pedicle drill template navigation were excellent and the position of pedicle screws was accurate as evaluated by postoperative radiology and CT scan. The correction rate of scoliosis was 60%. Navigation drill template group: the average operating duration was 186 min, average volume of blood loss 460 ml and frequency of radiation by C arm 4 times. the average operating duration was 225 min, average volume of blood loss 550 ml and frequency of radiation by C arm 30 times. The average operative duration between two groups was statistically significant (P < 0.01, t-test). And so were average volume of blood loss and frequency of radiation. The rapid prototyping of pedicle drill template navigation technology is a new method for accurate intra-operative insertion of pedicle screws. It has a high surgical accuracy and safety for spinal scoliosis. The application of pedicle drill template navigation is simple without special experience requirements for operators. It can shorten the operative duration and reduce blood lose. The exposure of operators to radiation may be reduced or avoided during fluoroscopy.