2026-03-07T18:53:46Z https://nagoya.repo.nii.ac.jp/oai

oai:nagoya.repo.nii.ac.jp:02011505 2024-09-05T04:59:17Z 499:508:509:1724896432553

A novel technique for C1-C2 posterior screw insertion using patient-specific guides created by CT-based 3D printing Kagami, Yujiro Nakashima, Hiroaki Segi, Naoki Ito, Sadayuki Ouchida, Jun Shinjo, Ryuichi Imagama, Shiro open access Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International C1-C2 fixation patient-specific screw guide templates C1 lateral mass screw screw accuracy C1-C2 fixation has been developed for the rigid fusion of atlantoaxial instability. C1 lateral mass screw (C1 LMS)-C2 pedicle screw fixation is used more frequently due to its rigid fixation and high bone fusion rate. However, C1 screw placement is relatively unsafe even with recently developed image-based navigation systems. Patient-specific screw guide templates (PSGT) were developed to improve the accuracy and safety of C1 screw placement. Herein, we investigated the outcomes of the C1-C2 posterior fixation technique using PSGT. This was a retrospective study of six patients who underwent posterior cervical spinal fusion using the PSGT between January 2022 and April 2023. Operative time, estimated blood loss, intraoperative radiation dose, surgical cost, and screw placement accuracy were evaluated and compared with those achieved with preoperative CT-based navigation (navigation group, n = 15). Screw accuracy was assessed using Neo’s classification. PSGT showed good results, although the differences were not statistically significant (operation time: 104.3 ± 9.7 min vs 116.4 ± 20.8 min; estimated blood loss: 56.7 ± 72.4 mL vs 123.2 ± 162.3 mL; and radiation dose: 1.8 ± 1.2 mSv vs 2.6 ± 0.8 mSv, respectively). PSGT was particularly better in terms of the accuracy of C1 LMS (PSGT: 100%, navigation: 83.3%). The deviation at the entry point was minimal, and the difference between the sagittal and transversal angles from the preoperative plan was small. We investigated the clinical efficacy of using the PSGT for C1-C2 posterior fixation. PSGT improved the accuracy of C1 LMS insertion. Nagoya University Graduate School of Medicine, School of Medicine 2024-08 eng departmental bulletin paper VoR https://doi.org/10.18999/nagjms.86.3.487 http://hdl.handle.net/2237/0002011505 https://nagoya.repo.nii.ac.jp/records/2011505 10.18999/nagjms.86.3.487 https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/863.html 0027-7622 2186-3326 Nagoya Journal of Medical Science 86 3 487 496 https://nagoya.repo.nii.ac.jp/record/2011505/files/13_Kagami.pdf application/pdf 25.6 MB 2024-08-29