Application of a 3D printed navigation template in posterior atlantoaxial surgery / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the efficacy of 3D printed navigation template in posterior atlantoaxial surgery.Methods:A retrospective study was conducted of the 22 patients who had received posterior atlantoaxial surgery for atlantoaxial diseases at The Second Department of Orthopedics, The Second Hospital Affiliated to Xi'an Jiao Tong University from September 2017 through February 2020. They were divided into a control group ( n=11) and an experimental group ( n=11) according to whether a 3D printed navigation template had been used to assist the posterior atlantoaxial surgery. In the control group, there were 6 males and 5 females, with an age of 63.6 years ± 4.6 years. In the experimental group, there were 7 males and 4 females, with an age of 57.6 years ± 4.8 years. In the control group, the pedicle screws were inserted with the help of conventional X-ray; in the experimental group, the pedicle screws were implanted with the assistance of a 3D printed navigation template and a 3D printed 3D model of cervical spine based on the preoperative CT data. Recorded were surgery time, times of intraoperative fluoroscopy, blood loss and success rate of pedicle screw insertion. Results:There were no significant differences between the 2 groups in the preoperative general data, showing comparability ( P>0.05). A total of 44 pedicle screws were inserted in the control group, including 12 ones of level-Ⅰ, 20 ones of level-Ⅱ and 12 ones of level-Ⅲ, giving a success rate of 72.7%; a total of 44 pedicle screws were inserted in the experimental group, including 21 ones of level-Ⅰ, 19 ones of level-Ⅱ and 4 ones of level-Ⅲ, giving a success rate of 90.9%. The success rate in the experimental group was significantly higher than in the control group ( P< 0.05). The surgery time (120.0 min± 5.0 min), times of tntraoperative fluoroscopy (9.9 times ±0.5 times), and blood loss (96.6 mL ± 4.2 mL) in the experimental group were significantly lower than those in the control group (153.1 min ± 5.3 min, 12.2 times ± 0.7 times and 128.5 mL ± 5.1 mL) ( P<0.05). Conclusion:Application of a 3D printing template can effectively reduce surgery time, intraoperative blood loss and intraoperative fluoroscopy but increase the success rate of pedicle screw implantation, showing excellent application prospects in posterior atlantoaxial surgery.