Turkish Neurosurgery
A novel method to improve the accuracy and stability of the 3D guide template technique applied in upper cervical spine surgery
Zhenshan Yuan1, Yong Hu1, Weixin Dong1, Jianbing Zhong1, Bingke Zhu1, Xiaoyang Sun1
1Ningbo No.6 Hospital, spine surgery, Ningbo,
DOI: 10.5137/1019-5149.JTN.40449-22.2

Aim:To evaluate the safety and accuracy of C1 and C2 pedicle screw placement using 3D printing double template compared with conventional method in clinical studyMaterial and Methods:The DICOM format data of 60 cases of C1-C2 instability were obtained after CT scanning. 32 cases underwent surgery by free-hand technique, 28 cases underwent surgery by 3D printing \"pointing-drilling\" guide template. The ideal trajectory of C1 and C2 pedicle screws was designed with a baseplate as a separate complementary template for the posterior C1-C2 corresponding anatomical surface, then \"pointing-drilling\" guide template in 3D printing machine was materialized. The 3D printing \"pointing-drilling\" guide template which was sterilized by low temperature plasma to apply for locate the starting point and drill the trajectory during the surgery. The position of screw in axial and sagittal plane of the CT scan was observed and categorized into 4 grades and the result of operation time, fluoroscopy times, and intraoperative bleeding in the two group were compared.Results:There was no statistically significant difference (p>0.05) in each grade of screw classification between free-hand group and \"pointing-drilling\" template group, but there was statistically significant difference (p=0.048) between these two groups. There was statistically significant difference (p<0.05) in fluoroscopy times between free-hand group and \"pointing-drilling\" template group. There was no statistically significant difference in bleeding(p=0.491) and operation time(p=0.309) between free-hand group and \"pointing-drilling\" template group.Conclusion:3D printing \"pointing-drilling\" guide template technique is more secure than free-hand technique in C1 and C2 pedicle screws placement in clinics

Corresponding author : Yong Hu