scholarly journals Three-Dimensional-Printed Drill Guides for Occipitothoracic Fusion in a Pediatric Patient With Occipitocervical Instability

2021 ◽  
Author(s):  
Peter A J Pijpker ◽  
Jos M A Kuijlen ◽  
Bart L Kaptein ◽  
Willem Pondaag
Keyword(s):  
Spinal Cord ◽  
Three Dimensional ◽  
Pedicle Screws ◽  
Cord Compression ◽  
Occipital Bone ◽  
The Novel ◽  
3D Technology ◽  
Screw Insertion ◽  
3D Printed ◽  
Keel Plate

Abstract BACKGROUND Pediatric occipitothoracic fusion can be challenging because of small size pedicles and thin occipital bone. Three-dimensional (3D) printing technology can help with accurate screw insertion but has not been described for occipital keel plate positioning so far. OBJECTIVE To describe the novel use of 3D technology to position occipital keel plates during pediatric occipitothoracic fixation. METHODS A young boy with segmental spinal dysgenesis presented with asymmetrical pyramidal paresis in all limbs. Developmental abnormities of the cervical spine caused a thinned spinal cord, and because of progressive spinal cord compression, surgical intervention by means of occipitothoracic fixation was indicated at the age of 3 yr. Because of the small-size pedicles and thin occipital bone, the pedicle screws and occipital plates were planned meticulously using 3D virtual surgical planning technology. The rods were virtually bent in order to properly align with the planned screws. By means of 3D-printed guides, the surgical plan was transferred to the operating theater. For the occipital bone, a novel guide concept was developed, aiming for screw positions at maximal bone thickness. RESULTS The postoperative course was uneventful, and radiographs showed good cervical alignment. After superimposing the virtual plan with the intraoperative acquired computed tomography, it was confirmed that the occipital plate positions matched the virtual plan and that pedicle screws were accurately inserted without signs of breach. CONCLUSION The use of 3D technology has greatly facilitated the performance of the occipitothoracic fixation and could, in the future, contribute to safer pediatric spinal fixation procedures.

scholarly journals 3D-Customized Guiding Template for Posterior Fixation in Complex Atlantoaxial Instability—Preliminary Experiences of National Cheng Kung University Hospital

2020 ◽  
Vol 81 (01) ◽  
pp. e20-e27
Author(s):  
Yi-Yun Chen ◽  
Liang-Chun Chao ◽  
Jing-Jing Fang ◽  
E-Jian Lee
Keyword(s):  
Three Dimensional ◽  
University Hospital ◽  
Atlantoaxial Instability ◽  
Posterior Fixation ◽  
Screw Insertion ◽  
Anatomical Abnormality ◽  
Spine Model ◽  
Atlantoaxial Fixation ◽  
3D Printed ◽  
Complex Cases

Objective Atlantoaxial fixation is technically demanding and challenging, especially in cases with anatomical abnormality. The purpose of this study is to report the effectiveness of the three-dimensional (3D)-customized guiding template for placement of C1 and C2 screws in cases with abnormalities. Method Two patients with anatomical abnormality and one without were included. The preoperative computed tomography (CT) image was analyzed using our software. The entry point, trajectory, and depth of the screws were designed based on these images. Templates with screw guiding cylinders and cervical spine model were created. In operation, guiding templates were applied directly to the laminae. Drilling, tapping, and screwing were performed through the cylinders. To evaluate the accuracy, deviation of the screw axis from the preplanned trajectory was measured on postoperative CT. A classification system was taking to evaluate the pedicle screw insertion. Results In complex cases, one of C2 screws has grade 2 deviation, and two has grade 1. There was no deviation in screws of C1. All patients achieved symptoms free after 6 months follow-up. Conclusion Although 3D-printed template for atlantoaxial fixation still has limitation in complex cases, it has been proved usefulness and makes the most difficult and dangerous spinal posterior fixation easy to achieve.

The Evaluation of a Novel Three-Dimensional Printed Expandable Pedicle Screw Sleeve Insert

2019 ◽  
Vol 13 (3) ◽  
Author(s):  
Timothy A. Burkhart ◽  
Manjunath Sadashivaiah ◽  
Jacob Reeves ◽  
Paraham Rasounlinejad
Keyword(s):  
Pedicle Screw ◽  
Vertebral Body ◽  
Degenerative Spondylolisthesis ◽  
Three Dimensional ◽  
Area Under The Curve ◽  
Tensile Load ◽  
The Novel ◽  
Conflicting Information ◽  
Screw Augmentation ◽  
3D Printed

When used in combination with decompression, spinal fusion is a successful procedure for treating patients with spinal stenosis and degenerative spondylolisthesis. While a number of auxiliary devices have been proposed to enhance the fixation of the screw within the pedicle and vertebral body, there is conflicting information regarding the efficacy of their use. Therefore, the aim of this study was to determine the ability of a novel expandable pedicle screw to improve the fixation of the pedicle screw within the pedicle and vertebral body. A three-dimensional (3D) printed, screw sleeve was designed that expanded within the pedicle and vertebral body when a standard pedicle screw was inserted into it. The left and right pedicle of ten (N = 10) cadaveric lumbar spine specimens (L3–L5) were randomly assigned to be instrumented with either a pedicle screw and the sleeve or a pedicle screw only. Following instrumentation, the screws were exposed to tensile load at 5 mm/min until failure. The failure force, failure deformation, and area under the force–deformation curve were determined and compared between screw conditions. There were no significant differences between the screws and sleeve, and the screw only conditions for the failure force (p = 0.24), failure displacement (p = 0.10), and area under the curve (p = 0.38). While the novel screw sleeve presented here performed as well as a screw without a sleeve, it was better than other screw augmentation devices reported previously. In addition, it is likely that this device would prove useful as an enhancement to revision.

Late Spinal Cord Compression Caused by Pulled-out Thoracic Pedicle Screws: A Case Report

Spine ◽  
2003 ◽  
Vol 28 (24) ◽  
pp. E506-E510 ◽  
Author(s):  
Ahmet Alanay ◽  
Akin Cil ◽  
Emre Acaroglu ◽  
Omur Caglar ◽  
Rahmican Akgun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Spinal Cord Compression ◽  
Pedicle Screws ◽  
Cord Compression ◽  
Thoracic Pedicle Screws

scholarly journals Bone registration method for robot assisted surgery: Pedicle screw insertion

1997 ◽  
Vol 211 (3) ◽  
pp. 221-233 ◽  
Author(s):  
K Abdel-Malek ◽  
D P McGowan ◽  
V K Goel ◽  
D Kowalski ◽  
S B Smith
Keyword(s):  
Pedicle Screw ◽  
Three Dimensional ◽  
Pedicle Screws ◽  
Bone Geometry ◽  
Registration Method ◽  
Screw Insertion ◽  
Manipulator Arm ◽  
Vertebral Bodies ◽  
Five Axis

A registration method that identifies bone geometry with respect to a robotic manipulator arm is presented. Although the method is generally applicable to many orthopaedic internal fixation procedures, it was only demonstrated for the insertion of pedicle screws in vertebral bodies for spine fixation. The method relies upon obtaining an impression of the vertebral bodies. Computerized tomography (CT) scans of both vertebrae and mould are reconstructed using a computer aided engineering (CAE) system. From the reconstructions, the surgeon is able to do preoperative planning including selection of pedicle screw diameter, direction of screw through pedicle, point of entry and length of engagement. The three-dimensional models are then meshed to determine positions of the surgeon's preoperative plan relative to the mould. Intra-operative positions are defined in space by a mechanical fixture rigidly attached to the mould and designed to allow a manipulator end-effector to recognize the global coordinates of the in vivo spine. The theory and methodology were validated using a five-axis manipulator arm. This initial presentation assumes and allows no relative motion between vertebrae in vivo.

scholarly journals A General Fruit Acid Chelation Route for Eco-friendly and Ambient 3D Printing of Metals

2021 ◽  
Author(s):  
Soo Young Cho ◽  
Dong Hae Ho ◽  
Yoon Young Choi ◽  
Soomook Lim ◽  
Sungjoo Lee ◽  
...  
Keyword(s):  
3D Printing ◽  
Industrial Revolution ◽  
Metal Chelate ◽  
Three Dimensional ◽  
Metal Particles ◽  
The Novel ◽  
Metal Powders ◽  
3D Printed ◽  
Metal 3D Printing ◽  
Metal Additive

Abstract Recent advances in metal additive manufacturing (AM) have provided new opportunities for the design of prototypes of metal-based products and personalization of products for the fourth industrial revolution. Although metal AM, which enables fabrication of varied and sophisticated objects, is in the spotlight as a next-generation printing method, environmental issues arising during the printing process need to be addressed before it can be commercialized. Here, we demonstrate a novel mechanism for binder jetting three-dimensional (3D) printing of metals that is based on chelation triggered by an eco-friendly binding agent. Sodium salts of fruit acid chelators are used to form stable metal-chelate bridges between metal particles, which enable elaborate metal 3D printing. The strength of the 3D-printed object is improved by post-treatment, through a reduction in the porosity between the metal particles. Finally, the compatibility of the novel printing mechanism with a variety of metals is demonstrated via successful 3D printing of objects of various shapes using various metal powders. The proposed mechanism for metal 3D printing is expected to open up new avenues for the development of domestic-scale desktop 3D printing of metals.

Autotransplantation of a surgically removed canine using a customised 3D-printed surgical template

2020 ◽  
Vol 47 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Jacob M T Curtis ◽  
Emma C Foster ◽  
Sankaranarayanan Ananth ◽  
Charlotte E Eckhardt ◽  
Jeremy Knox ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Survival Rates ◽  
Three Dimensional ◽  
The Novel ◽  
Anterior Maxilla ◽  
Digital Planning ◽  
3D Printed ◽  
Planning And Construction ◽  
Surgical Templates ◽  
Tomography Scan

Autotransplantation is a treatment option with high reported survival rates to replace failing teeth in the anterior maxilla. This treatment requires a multidisciplinary approach from orthodontists, paediatric dentists, restorative dentists, and oral and maxillofacial surgeons to achieve successful outcomes. Success is dependent on many factors including stage of root development, handling of the periodontal ligament, extra-alveolar time and splinting. This case report presents the novel use of digitally designed and three-dimensional (3D) printed surgical templates to aid intraoperatively and reduce the extra-alveolar time. A preoperative cone-beam computed tomography scan allowed digital planning and construction of surgical templates that replicated the exact root dimensions of impacted maxillary canines. These templates were subsequently 3D printed in resin, sterilised and utilised intraoperatively to aid socket preparation before the surgical autotransplantation.

Accuracy of Placement of Pedicle Screws in the Lumbosacral Region of Dogs Using 3D-Printed Patient-Specific Drill Guides

2020 ◽  
Author(s):  
Cristina Toni ◽  
Bill Oxley ◽  
Stephen Clarke ◽  
Sebastien Behr
Keyword(s):  
Cauda Equina ◽  
Three Dimensional ◽  
Clinical Signs ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Patient Specific ◽  
Inclusion Criteria ◽  
Lumbosacral Region ◽  
Dorsal Stabilization ◽  
3D Printed

Abstract Objective The aim of this study was to report the accuracy of pedicle screw placement using three-dimensional (3D)-printed, patient-specific drill guides in the lumbosacral region of dogs. Study Design This was a retrospective study. Thirty-two pedicle screws were placed in five dogs. Medical records were reviewed between November 2015 and November 2018 for dogs showing clinical signs associated with cauda equina syndrome. Inclusion criteria included preoperative magnetic resonance imaging, pre- and postoperative computed tomography (CT) and dorsal stabilization, with pedicle screws placed using 3D-printed, patient-specific drill guides and polymethylmethacrylate. Screw placement was evaluated for medial or lateral breaching on postoperative CT. Results Five dogs met the inclusion criteria. Four had degenerative lumbosacral stenosis and one had discospondylitis. All dogs had failed medical management prior to surgery. Of 32 bicortical pedicle screws placed, 30 were fully contained inside the pedicle and 2 were partially breaching the vertebral canal (less than one-third of the screw diameter). Postoperative CT revealed good alignment of L7-S1 in all planes. Conclusions This technique enabled an accurate and safe placement of pedicle screws in the lumbosacral region of dogs with lumbosacral disease. Three-dimensional, printed patient-specific drill guides are a safe and effective method of placing pedicle screws in dogs with lumbosacral disease.

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