Computer-assisted orthopedic surgery with individual templates and comparison to conventional operation method.
Study Design: Comparison was made of the accuracy of a pedicle bore performed by conventional technique and by using an individual template in the lumbar spine of cadavers.Objectives: The fixation of pedicle screws necessitates a high amount of surgical skill and experience to avoid lesions of nerve...
| Publicado en: | Spine (03622436) Vol. 26; no. 4; pp. 365 - 371 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
2001 Feb 15
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138085752&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138085752 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03622436 1Y6 jtl: Spine (03622436) issn: 03622436 maglogo: N pubinfo: dt: 2001 Feb 15 vid: 26 iid: 4 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 138085752 138085752 NLM11224883 138085752 10.1097/00007632-200102150-00012 NLM11224883 138085752 ppf: 365 ppct: 6 formats: tig: atl: Computer-assisted orthopedic surgery with individual templates and comparison to conventional operation method. aug: au: Birnbaum, K Schkommodau, E Decker, N Prescher, A Klapper, U Radermacher, K affil: Orthopedic Department, the Helmholtz Institute for Biomedical Technique, and the Anatomical Institute, University Hospital of the Rheinisch-Westfaelische Technische Hochschule, Aachen, Germany sug: subj: Spinal Fusion Methods Spinal Fusion Equipment and Supplies Image Processing, Computer Assisted Methods Image Processing, Computer Assisted Equipment and Supplies Lumbar Vertebrae Surgery Spinal Diseases Surgery Human Bone Screws Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales ab: Study Design: Comparison was made of the accuracy of a pedicle bore performed by conventional technique and by using an individual template in the lumbar spine of cadavers.Objectives: The fixation of pedicle screws necessitates a high amount of surgical skill and experience to avoid lesions of nerves and vessels. By using individual templates in a cadaver study the goal was to prove the accuracy and efficiency of this less-invasive image-guided surgery in comparison with the conventional technique by fluoroscopy and computed tomographic (CT) scan.Summary Of Background Data: Based on three-dimensional models generated from CT scans of the lumbar spine, precise preoperative planning of the position and trajectory of pedicle screws is possible. In comparison with other means of computer-assisted spine surgery with navigation systems, in which a time-consuming intraoperative matching of the bone surface structure is necessary, the use of individual templates enables the surgeon to reduce the operation time considerably.Methods: Individual templates are customized on the basis of three-dimensional reconstructions of the bone structures extracted from CT image data and depending on the individual preoperative surgical planning, which uses the desktop image processing system for orthopedic surgery (DISOS). A desktop-computer-controlled milling device is used as a three-dimensional printer to automatically mold the shape of small reference areas of the bone surface into the body of the template. Postoperative CT scans were obtained and the accuracy of the pedicle bore rated by two independent observers.Results: The preparation time with the individual template lasted slightly longer than with the conventional operation technique (555 seconds and 482 seconds, respectively). Fluoroscopic study took a mean time of 31.5 seconds, with the conventional operation technique and 5.5 seconds with the individual template. The assessment of the postoperative CT scans demonstrated a higher accuracy of the pedicle bore with the individual template.Conclusions: This cadaveric study has shown that overall operation time including the fluoroscopy time can be shortened by using the individual template for the pedicle bore. The individual template is an alternative to the computer-assisted navigation systems with a good cost-performance ratio without excessive technical workload on the physicians or the surgical personnel. Further investigations must be conducted to validate the clinical applicability of this system. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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