Accuracy of lumbar pedicle screw implantation based on three-dimensional printing navigation modules / 中国组织工程研究

ABSTRACT

BACKGROUND: The surgical procedure of pedicle screw placement in the lumbar spine requires a long time to confirm the insertion position of the pedicle screw by using X-ray images. The clinical application of computer-aided navigation techniques is limited, due to the high cost of auxiliary navigation system and complicated operation. OBJECTIVE: Based on three-dimensional printing navigation module of lumbar pedicle screw implantation in patients with fracture of lumbar spine, to verify the accuracy and feasibility of the navigation module into lumbar pedicle screws. METHODS: According to CT data of 50 patients with fracture of lumbar vertebra, the data were loaded into Mimics to establish a three-dimensional model of the lumbar spine. On the basis of the established model of pedicle screw navigation module, lumbar entity model and navigation module were made using three-dimensional printing technology. First of all, navigation module was preoperatively embedded in the lumbar spine specimen entity to simulate pedicle screw test. Second, screw navigation module was applied to assist lumbar pedicle screw insertion in lumbar vertebra during the operation. After operation, the effectiveness of the screw implantation was assessed using CT examination and X-ray. RESULTS AND CONCLUSION: (1) The designed navigation module with 12 pedicle screws was inserted into lumbar vertebra. CT examination showed that screw position was good on the internal side of lumbar pedicle; no screws perforated the pedicle cortex. (2) Experiments showed that the accuracy of pedicle screws inserted into lumbar vertebra was relatively high. The direction and the site of the screws were basically identical to the preoperative simulation results. (3) Based on three-dimensional printing navigation module, the accuracy of pedicle screw implantation into the vertebral vertebra was high, and could realize accurate implantation of individualized pedicle screws. The minimally invasive surgery method is relatively simple and has the very vital significance.