Abstract
The aim of this
study was to investigate the effect of surgical planning and application on the
clinical outcomes of preoperative models of patients who underwent posterior C1
- C2 fusion using C1 lateral mass - C2 pedicle screw technique.
Eleven patients who
were admitted to our clinic with atlantoaxial dislocation were included in this
study. Fused deposition modeling three-dimensional printer with special design
was used for the production of three-dimensional printing material. Surgical
planning was performed on preoperative models and applied. The mean age of the
patients was 52.54 ± 20.45 years (24-75). Of the 11 patients, 7 were male
(63.6%), 4 were female (36.4%). Two (18.2%) of these patients had congenital
dislocation, 9 (81.8%) were admitted to
our clinic due to trauma. The mean operation time of the patients was 260.90 ±
79.17 min. The mean preoperative atlantodental interval was 3.44 ± 1.38 mm and
the mean postoperative atlantodental interval was 2.20 ± 0.89 mm. C1-C2 fusion
with preoperative three-dimensional modeling is an effective method in the
treatment of atlantoaxial dislocation. The use of these models offers surgeons
advantages by increasing the ability to perform preoperative simulation. The 3D
modeling technique reduces screw malposition during surgery and shortens the
operation time and increases intraoperative safety.
References
- 1. Zheng Y, Hao D, Wang B, He B, Hu H, Zhang H. Clinical outcome of posterior C1-C2 pedicle screw fixation and fusion for atlantoaxial instability: A retrospective study of 86 patients. J Clin Neurosci. 2016;32:47-50.
- 2. Dickman CA, Sonntag VK, Papadopoulos SM, Hadley MN. The interspinous method of posterior atlantoaxial arthrodesis. J Neurosurg. 1991;74(2):190-8.
- 3. Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine. 2001;26(22):2467-71.
- 4. Huang DG, Hao DJ, He BR, Wu QN, Liu TJ, Wang XD, et al. Posterior atlantoaxial fixation: a review of all techniques. The spine journal : official journal of the North American Spine Society. 2015;15(10):2271-81.
- 5. Winegar CD, Lawrence JP, Friel BC, Fernandez C, Hong J, Maltenfort M, et al. A systematic review of occipital cervical fusion: techniques and outcomes. J Neurosurg Spine. 2010;13(1):5-16.
- 6. Akinduro OO, Baum GR, Howard BM, Pradilla G, Grossberg JA, Rodts GE, Jr., et al. Neurological outcomes following iatrogenic vascular injury during posterior atlanto-axial instrumentation. Clin Neurol Neurosurg. 2016;150:110-6.
- 7. Vakharia VN, Vakharia NN, Hill CS. Review of 3-Dimensional Printing on Cranial Neurosurgery Simulation Training. World Neurosurg. 2016;88:188-98.
- 8. Ploch CC, Mansi C, Jayamohan J, Kuhl E. Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning. World Neurosurg. 2016;90:668-74.
- 9. Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, et al. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg. 2010;5(4):335-41.
- 10. Elliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-Boadu A, et al. Atlantoaxial fusion with transarticular screws: meta-analysis and review of the literature. World Neurosurg. 2013;80(5):627-41.
- 11. Elliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-Boadu A, et al. Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. Journal of spinal disorders & techniques. 2014;27(1):11-28.
- 12. Gao F, Wang Q, Liu C, Xiong B, Luo T. Individualized 3D printed model-assisted posterior screw fixation for the treatment of craniovertebral junction abnormality: a retrospective study. J Neurosurg Spine. 2017;27(1):29-34.
- 13. Yang YL, Zhou DS, He JL. Comparison of isocentric C-arm 3-dimensional navigation and conventional fluoroscopy for C1 lateral mass and C2 pedicle screw placement for atlantoaxial instability. Journal of spinal disorders & techniques. 2013;26(3):127-34.
- 14. Jing L, Sun Z, Zhang P, Wang J, Wang G. Accuracy of Screw Placement and Clinical Outcomes After O-Arm-Navigated Occipitocervical Fusion. World Neurosurg. 2018;117:e653-e9.
- 15. Sai Kiran NA, Sivaraju L, Vidyasagar K, Aryan S, Raj V, Rajagopal N, et al. Safety and Accuracy of Anatomic and Lateral Fluoroscopic-Guided Placement of C2 Pars/Pedicle Screws and C1 Lateral Mass Screws, and Freehand Placement of C2 Laminar Screws. World Neurosurg.2018;118:e304-e15
Abstract
Bu çalışmanın
amacı, C1 lateral mass - C2 pedikül vidalama kullanılarak posterior C1 – C2
füzyon yapılacak olan hastaların 3 boyutlu (3B) yazıcı ile oluşturulan
preoperatif modelleri üzerinde cerrahi planlama ve uygulamasının klinik
sonuçlara etkisini araştırmaktır. Kliniklerimize atlantoaksiyel dislokasyon
nedeniyle başvuran 11 hasta bu çalışmaya alınmıştır. Üç boyutlu baskı
materyalinin üretimi için özel tasarımlı katmanlı üretim teknolojisi olan üç
boyutlu yazıcı kullanıldı. Preoperatif modeller üzerinde cerrahi planlama
yapıldı ve uygulandı. Hastaların yaş ortalaması 52.54±20.45 yaş (24-75) idi. 11
hastanın 7’si erkek (%63.6), 4’ü kadındı (%36.4). Bu hastaların 2’si (%18.2)
konjenital anomali nedenli, 9’u (%81.8) travma nedeniyle kliniğimize başvurdu.
Hastaların operasyon süresi ortalama 260.90±79.17 dakika idi. Preoperatif
atlantodental aralık ortalaması 3.44±1.38 mm, postoperatif atlantodental aralık
ortalaması 2.20±0.89 mm olarak bulundu. Preoperatif üç boyutlu modellemenin
yardımı ile yapılan C1-C2 füzyonu atlantoaksiyel dislokasyonun tedavisinde
etkili bir yöntemdir. Bu modellerin kullanımı, ameliyat öncesi simülasyon yapma
becerisini artırarak cerrahlara avantajlar sunar. 3B’lu modelleme tekniği ameliyat
sırasında, vida malpozisyonu azaltır, ameliyat süresini kısaltarak intraoperatif
güvenliği artırır.
References
- 1. Zheng Y, Hao D, Wang B, He B, Hu H, Zhang H. Clinical outcome of posterior C1-C2 pedicle screw fixation and fusion for atlantoaxial instability: A retrospective study of 86 patients. J Clin Neurosci. 2016;32:47-50.
- 2. Dickman CA, Sonntag VK, Papadopoulos SM, Hadley MN. The interspinous method of posterior atlantoaxial arthrodesis. J Neurosurg. 1991;74(2):190-8.
- 3. Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine. 2001;26(22):2467-71.
- 4. Huang DG, Hao DJ, He BR, Wu QN, Liu TJ, Wang XD, et al. Posterior atlantoaxial fixation: a review of all techniques. The spine journal : official journal of the North American Spine Society. 2015;15(10):2271-81.
- 5. Winegar CD, Lawrence JP, Friel BC, Fernandez C, Hong J, Maltenfort M, et al. A systematic review of occipital cervical fusion: techniques and outcomes. J Neurosurg Spine. 2010;13(1):5-16.
- 6. Akinduro OO, Baum GR, Howard BM, Pradilla G, Grossberg JA, Rodts GE, Jr., et al. Neurological outcomes following iatrogenic vascular injury during posterior atlanto-axial instrumentation. Clin Neurol Neurosurg. 2016;150:110-6.
- 7. Vakharia VN, Vakharia NN, Hill CS. Review of 3-Dimensional Printing on Cranial Neurosurgery Simulation Training. World Neurosurg. 2016;88:188-98.
- 8. Ploch CC, Mansi C, Jayamohan J, Kuhl E. Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning. World Neurosurg. 2016;90:668-74.
- 9. Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, et al. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg. 2010;5(4):335-41.
- 10. Elliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-Boadu A, et al. Atlantoaxial fusion with transarticular screws: meta-analysis and review of the literature. World Neurosurg. 2013;80(5):627-41.
- 11. Elliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-Boadu A, et al. Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. Journal of spinal disorders & techniques. 2014;27(1):11-28.
- 12. Gao F, Wang Q, Liu C, Xiong B, Luo T. Individualized 3D printed model-assisted posterior screw fixation for the treatment of craniovertebral junction abnormality: a retrospective study. J Neurosurg Spine. 2017;27(1):29-34.
- 13. Yang YL, Zhou DS, He JL. Comparison of isocentric C-arm 3-dimensional navigation and conventional fluoroscopy for C1 lateral mass and C2 pedicle screw placement for atlantoaxial instability. Journal of spinal disorders & techniques. 2013;26(3):127-34.
- 14. Jing L, Sun Z, Zhang P, Wang J, Wang G. Accuracy of Screw Placement and Clinical Outcomes After O-Arm-Navigated Occipitocervical Fusion. World Neurosurg. 2018;117:e653-e9.
- 15. Sai Kiran NA, Sivaraju L, Vidyasagar K, Aryan S, Raj V, Rajagopal N, et al. Safety and Accuracy of Anatomic and Lateral Fluoroscopic-Guided Placement of C2 Pars/Pedicle Screws and C1 Lateral Mass Screws, and Freehand Placement of C2 Laminar Screws. World Neurosurg.2018;118:e304-e15
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | ORİJİNAL MAKALE |
| Authors | |
| Publication Date | October 1, 2019 |
| Published in Issue | Year 2019 Volume: 41 Issue: 4 |