title: Accuracy Assessment of Using Rapid Prototyping Drill Templates for Atlantoaxial Screw Placement: A Cadaver Study.
abstract: Purpose.To preliminarily evaluate the feasibility and accuracy of using rapid prototyping drill templates (RPDTs) for C1 lateral mass screw (C1-LMS) and C2 pedicle screw (C2-PS) placement.Methods.23 formalin-fixed craniocervical cadaver specimens were randomly divided into two groups. In the conventional method group, intraoperative fluoroscopy was used to assist the screw placement. In the RPDT navigation group, specific RPDTs were constructed for each specimen and were used intraoperatively for screw placement navigation. The screw position, the operating time, and the fluoroscopy time for each screw placement were compared between the 2 groups.Results.Compared with the conventional method, the RPDT technique significantly increased the placement accuracy of the C2-PS (p< 0.05). In the axial plane, using RPDTs also significantly increased C1-LMS placement accuracy (p< 0.05). In the sagittal plane, although using RPDTs had a very high accuracy rate (100%) in C1-LMS placement, it was not statistically significant compared with the conventional method (p> 0.05). Moreover, the RPDT technique significantly decreased the operating and fluoroscopy times.Conclusion.Using RPDTs significantly increases the accuracy of C1-LMS and C2-PS placement while decreasing the screw placement time and the radiation exposure. Due to these advantages, this approach is worth promoting for use in the Harms technique.
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Teng
authors.initials: T
authors.lastname: Lu
authors.affiliation: Department of Orthopaedics, Second Hospital of Yulin City, Yulin, Shaanxi Province 719000, China.
authors.forename: Qiaolong
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Baohui
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Xijing
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Haopeng
authors.identifier: 0000-0002-2162-6358
authors.initials: H
authors.lastname: Li
mesh_terms: D000368:Aged; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D002102:Cadaver; D005240:Feasibility Studies; D005471:Fluoroscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D061646:Operative Time; D065289:Pedicle Screws; D017755:Prosthesis Fitting / Q000295:instrumentation* / Q000379:methods; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*