A Minimally Invasive Technique Using Cortical Bone Trajectory Screws Assisted by 3D-Printed Navigation Templates in Lumbar Adjacent Segment Degeneration
Kun He,1,2,* Chunke Dong,3,* Hongyu Wei,2,* Feng Yang,2 Haoning Ma,2 Xiangsheng Tang,2 Mingsheng Tan,2 Ping Yi2 1Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 2Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing,...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/8efa16f4960444a5a3d0210b6ef34263 |
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| Sumario: | Kun He,1,2,* Chunke Dong,3,* Hongyu Wei,2,* Feng Yang,2 Haoning Ma,2 Xiangsheng Tang,2 Mingsheng Tan,2 Ping Yi2 1Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 2Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China; 3Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping Yi; Mingsheng Tan Email zryiping@163.com; zrtanms@163.comPurpose: Revision surgery for adjacent segment degeneration (ASD) commonly requires exposing and removing the original fixation. To minimize trauma and to reduce the operation time and blood loss, we introduced a minimally invasive lumbar revision technique using cortical bone trajectory (CBT) screws assisted by three-dimensional (3D)-printed navigation templates.Methods: From April 2017 to October 2019, 18 patients with ASD underwent revision surgery with CBT screws assisted by 3D-printed templates in our hospital. All surgical data, including the operation time, blood loss, and incision length, were recorded. We evaluated the clinical efficacy using the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Japanese Orthopedic Association (JOA) score. X-ray and computed tomography (CT) scans were used to evaluate the stability of CBT screw fixation, the accuracy of screws, and the fusion rate.Results: The mean follow-up was 22.4± 4.7 months (12– 31 months). The VAS, ODI, and JOA scores were analyzed by SPSS 21.0 and showed significant improvement at 2 weeks and the last follow-up compared with preoperative data (P< 0.05). Seventy-six CBT screws were inserted with navigation templates; 2 screws were Grade B, and the other screws were Grade 0 or A. Changes in intervertebral height showed good stability of CBT screw fixation (P> 0.05). All the patients exhibited satisfactory fusion results.Conclusion: Revision surgery for ASD with CBT screws assisted by 3D-printed navigation templates has satisfactory clinical efficacy with the advantages of a short operation time, a small incision, and less blood loss.Keywords: adjacent segment degeneration, cortical bone trajectory, revision surgery, 3D printing, navigation template |
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