An optimal design for patient‐specific templates for pedicle spine screws placement. Issue 3 (15th May 2012)

• Record Type: Journal Article
• Authors: Ferrari, V.; Parchi, P.; Condino, S.; Carbone, M.; Baluganti, A.; Ferrari, M.; Mosca, F.; Lisanti, M.
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 9:Issue 3(2013)
• Page Start: 298
• Page End: 304
• Publication Date: 2012-05-15
• Subjects: Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.1439
• Languages: English
• ISSNs: 1478-5951

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="rcs1439-sec-0001" sec-type="section"> <title>Background</title> <p>Currently, pedicle screws are positioned using a free‐hand technique or under fluoroscopic guidance, with error in the range 10–40%, depending on the skill of the surgeon.</p> </sec> <sec id="rcs1439-sec-0002" sec-type="section"> <title>Methods</title> <p>After spine CT acquisition, each vertebra is segmented and the surgeon plans screw positioning in a virtual environment, then the template is designed around the chosen trajectories. This design is based on surgical and mechanical considerations to obtain an optimal solution to guarantee template stability, simple positioning and minimized intervention invasiveness. <italic>In vitro</italic> evaluation on synthetic spine models and <italic>ex vivo</italic> animal tests on porcine specimens were performed, with the insertion of 28 Kirschner wires.</p> </sec> <sec id="rcs1439-sec-0003" sec-type="section"> <title>Results</title> <p>During the <italic>in vitro</italic> tests, all the surgeons rendered positive evaluations regarding the device and considered template placement to be easy. <italic>Ex vivo</italic> tests were evaluated by CT examination, which showed that 96.5% of the Kirschner wires had been correctly inserted.</p> </sec> <sec id="rcs1439-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The proposed solution is a promising, simple, highly precise, low‐cost solution to safely performing posterior stabilization. Such a solution would be of interest even in hospitals in which a few spine interventions are performed per year, and for which it is not reasonable to purchase the equipment required for robotic or navigated approaches. Copyright © 2012 John Wiley & Sons, Ltd.</p> </sec> </abstract>