The development and evaluation of individualized templates to assist transoral C2 articular mass or transpedicular screw placement in TARP-IV procedures: adult cadaver specimen study
Clinics
;
69(11): 750-757, 11/2014. tab, graf
Article
in English
| LILACS
| ID: lil-731106
ABSTRACT
OBJECTIVES:
The transoral atlantoaxial reduction plate system treats irreducible atlantoaxial dislocation from transoral atlantoaxial reduction plate-I to transoral atlantoaxial reduction plate-III. However, this system has demonstrated problems associated with screw loosening, atlantoaxial fixation and concealed or manifest neurovascular injuries. This study sought to design a set of individualized templates to improve the accuracy of anterior C2 screw placement in the transoral atlantoaxial reduction plate-IV procedure.METHODS:
A set of individualized templates was designed according to thin-slice computed tomography data obtained from 10 human cadavers. The templates contained cubic modules and drill guides to facilitate transoral atlantoaxial reduction plate positioning and anterior C2 screw placement. We performed 2 stages of cadaveric experiments with 2 cadavers in stage one and 8 in stage two. Finally, guided C2 screw placement was evaluated by reading postoperative computed tomography images and comparing the planned and inserted screw trajectories.RESULTS:
There were two cortical breaching screws in stage one and three in stage two, but only the cortical breaching screws in stage one were ranked critical. In stage two, the planned entry points and the transverse angles of the anterior C2 screws could be simulated, whereas the declination angles could not be simulated due to intraoperative blockage of the drill bit and screwdriver by the upper teeth.CONCLUSIONS:
It was feasible to use individualized templates to guide transoral C2 screw placement. Thus, these drill templates combined with transoral atlantoaxial reduction plate-IV, may improve the accuracy of transoral C2 screw placement and reduce related neurovascular complications. .
Full text:
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Index:
LILACS (Americas)
Main subject:
Atlanto-Axial Joint
/
Bone Screws
/
Cervical Vertebrae
/
Orthopedic Procedures
/
Joint Dislocations
Type of study:
Evaluation studies
Limits:
Adult
/
Humans
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2014
Type:
Article
/
Project document
Affiliation country:
China
Institution/Affiliation country:
Guangzhou General Hospital of Guangzhou Military Command (Liuhuaqiao Hospital)/CN
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