title: Deviation analysis for C1/2 pedicle screw placement using a three-dimensional printed drilling guide.
abstract: Cervical transarticular fixation is a technically demanding procedure. This study aimed to develop a safer and more accurate method for C1/2 pedicle screw placement using a three-dimensional printed drilling guide. A total of 20 patients with C1/2 fractures and dislocations were recruited, and their computed tomography scans were evaluated. Under the assistance of the three-dimensional printed drilling guide, bilateral C1/2 pedicle screws were successfully placed in the three-dimensional C1/2 models. Then, sagittal and axial computed tomography scans were obtained, and the accuracy and safety of screw placement were evaluated based on X-Y-Z axis setup. The average depths for C1 and C2 pedicle screws were 30.1 ± 1.12 and 31.81 ± 0.85 mm on the left side and 29.54 ± 1.01 and 31.35 ± 0.27 mm on the right side, respectively. The average dimensional parameters for C1/C2 pedicle screw of both sides were measured and analyzed, which showed no statistically significant differences in the ideal and the actual entry points, inclined angles, and tailed angles. The method of developing a three-dimensional printed drilling guide is an easy and safe technique. This novel technique is applicable for C1/2 pedicle screw fixation; the potential use of the three-dimensional printed guide to place C1/2 pedicle screw is promising.
authors.affiliation: 1 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xinghuo
authors.initials: X
authors.lastname: Wu
authors.affiliation: 2 Department of Orthopaedic Surgery, Puren Hospital of Wuhan, Wuhan University of Science and Technology, Wuhan, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Liu
authors.affiliation: 3 Department of radiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yu
authors.affiliation: 1 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.affiliation: 1 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Cao
authors.initials: C
authors.lastname: Yang
authors.affiliation: 1 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zengwu
authors.initials: Z
authors.lastname: Shao
authors.affiliation: 1 Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhewei
authors.initials: Z
authors.lastname: Ye
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D019637:Orthopedic Procedures / Q000295:instrumentation*; D065289:Pedicle Screws; D066330:Printing, Three-Dimensional; D012449:Safety
keywords: Pedicle screw; guide; placement; print; three-dimensional