title: A low invasiveness patient's specific template for spine surgery.
abstract: Free-hand pedicle screw placement is still conventional in surgery, although it has potentially high risks. The surgical procedures such as pedicle screw placement are usually designed based on medical imaging, but during surgery, the procedures are not normally followed due to the fact that some points are missed in two-dimensional images and seen only during surgery. In this regards, some highly accurate computer-assisted systems have been proposed and are currently used. Moreover, it is possible to reduce or completely avoid hand working by applying modern digital technology. Therefore, using these technologies has remarkable advantages. In this study, we have presented a new approach of pedicle screw placement in the lumbar and sacral regions using a specific drill guide template. The template was created by additive manufacturing technology and was verified in a clinical study as well. The main aim of this research includes the following: design, analyze, manufacture and evaluate the accuracy of a new patient-specific drill guide template, for lumbar pedicle screw placement, and compare the template to the free-hand technique under fluoroscopy supervision. Our results show that the incidence of cortex perforation is substantially reduced compared to existing methods. Finally, we believe that this approach remarkably lowers the incidence of cortex perforation and could be potentially used in clinical applications, particularly in certain selected cases.
authors.affiliation: 1 Department of Biomechanics, Science and Research Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Azimifar
authors.affiliation: 1 Department of Biomechanics, Science and Research Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Hassani
authors.affiliation: 2 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Saveh
authors.affiliation: 3 Pediatric Neurorehabilitation Research Center, Ergonomics Department, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Tabatabai Ghomshe
mesh_terms: D001696:Biomechanical Phenomena; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D066230:Patient-Specific Modeling; D065289:Pedicle Screws; D012447:Sacrum / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed
keywords: Spine; drill; guide; surgery; template