C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion
Abstract Background 3-D printing technology has a large spectrum of applications in upper cervical spinal surgery, but none have evaluated the radiological analysis of the feasibility of C2 pedicle screw placement. Thus, this study aimed to perform 3.5-mm-diameter C2 pedicle screw placement on model...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03498-x |
| _version_ | 1828069487631400960 |
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| author | Yuelin Wu Zhaoquan Liang Junhao Bao Ling Wen Li Zhang |
| author_facet | Yuelin Wu Zhaoquan Liang Junhao Bao Ling Wen Li Zhang |
| author_sort | Yuelin Wu |
| collection | DOAJ |
| description | Abstract Background 3-D printing technology has a large spectrum of applications in upper cervical spinal surgery, but none have evaluated the radiological analysis of the feasibility of C2 pedicle screw placement. Thus, this study aimed to perform 3.5-mm-diameter C2 pedicle screw placement on models for performance assessment of CTA-based preoperative screw preclusion. Methods We enrolled 152 patients who underwent CTA of the cervical spine between April 2020 and December 2020. Transverse pediculoisthmic width (TPW), oblique pediculoisthmic width (OPW), minimum pediculoisthmic diameter (MPD), internal height, and isthmus height were measured preoperatively. Subsequently, 1:1 3D-printed bone models were created, and a 3.5-mm-diameter C2 pedicle screw was placed on the models. All 3D-printed models underwent postoperative CT multiplanar reconstruction to evaluate the screw trajectory for the performance assessment of CTA-based preoperative screw preclusion. Results The ROC curves of the MPD, TPW, OPW, Internal height and Isthmus height showed that the optimal cutoff values for each of the five groups were measured values of 4.78, 4.44, 4.37, 4.22 and 5.59 mm, respectively. The AUC, sensitivity, and specificity of MPD were 0.992, 95.1% and 100%, respectively. The MPD had higher metrics than the TPW (AUC, 0.949; sensitivity, 87.9%), internal height (AUC, 0.885; sensitivity, 80.8%; specificity, 84.6%), and isthmus height (AUC, 0.941; sensitivity, 87.2%). We found no evidence of a difference between MPD and OPW in terms of the AUC and sensitivity (0.93 and 95.5%, respectively). Conclusions C2 pedicle screw placement on 3D-printed models is useful for performance assessment of CTA-based preoperative screw preclusion. MPD measurement with CTA multiplanar reconstruction showed the best performance for judging acceptable or unacceptable screws. However, the definition of HRVA could be modified by a 4.2 mm-internal height or by measuring only the isthmus height for judging the preclusion of C2 pedicle screw placement. |
| first_indexed | 2024-04-11T00:20:45Z |
| format | Article |
| id | doaj.art-6b47fceec4d4499dbcb423ed8026346c |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T00:20:45Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-6b47fceec4d4499dbcb423ed8026346c2023-01-08T12:16:44ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-01-011811810.1186/s13018-023-03498-xC2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusionYuelin Wu0Zhaoquan Liang1Junhao Bao2Ling Wen3Li Zhang4The Second School of Clinical Medicine, Southern Medical UniversityThe Second School of Clinical Medicine, Southern Medical UniversityThe Second School of Clinical Medicine, Southern Medical UniversityThe Spine Department, Orthopaedic Center, Guangdong Second Provincial General HospitalThe Second School of Clinical Medicine, Southern Medical UniversityAbstract Background 3-D printing technology has a large spectrum of applications in upper cervical spinal surgery, but none have evaluated the radiological analysis of the feasibility of C2 pedicle screw placement. Thus, this study aimed to perform 3.5-mm-diameter C2 pedicle screw placement on models for performance assessment of CTA-based preoperative screw preclusion. Methods We enrolled 152 patients who underwent CTA of the cervical spine between April 2020 and December 2020. Transverse pediculoisthmic width (TPW), oblique pediculoisthmic width (OPW), minimum pediculoisthmic diameter (MPD), internal height, and isthmus height were measured preoperatively. Subsequently, 1:1 3D-printed bone models were created, and a 3.5-mm-diameter C2 pedicle screw was placed on the models. All 3D-printed models underwent postoperative CT multiplanar reconstruction to evaluate the screw trajectory for the performance assessment of CTA-based preoperative screw preclusion. Results The ROC curves of the MPD, TPW, OPW, Internal height and Isthmus height showed that the optimal cutoff values for each of the five groups were measured values of 4.78, 4.44, 4.37, 4.22 and 5.59 mm, respectively. The AUC, sensitivity, and specificity of MPD were 0.992, 95.1% and 100%, respectively. The MPD had higher metrics than the TPW (AUC, 0.949; sensitivity, 87.9%), internal height (AUC, 0.885; sensitivity, 80.8%; specificity, 84.6%), and isthmus height (AUC, 0.941; sensitivity, 87.2%). We found no evidence of a difference between MPD and OPW in terms of the AUC and sensitivity (0.93 and 95.5%, respectively). Conclusions C2 pedicle screw placement on 3D-printed models is useful for performance assessment of CTA-based preoperative screw preclusion. MPD measurement with CTA multiplanar reconstruction showed the best performance for judging acceptable or unacceptable screws. However, the definition of HRVA could be modified by a 4.2 mm-internal height or by measuring only the isthmus height for judging the preclusion of C2 pedicle screw placement.https://doi.org/10.1186/s13018-023-03498-xC2 pediculoisthmic component3-D printingC2 pedicle screwMultiplanar reconstructionHigh-riding vertebral artery |
| spellingShingle | Yuelin Wu Zhaoquan Liang Junhao Bao Ling Wen Li Zhang C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion Journal of Orthopaedic Surgery and Research C2 pediculoisthmic component 3-D printing C2 pedicle screw Multiplanar reconstruction High-riding vertebral artery |
| title | C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion |
| title_full | C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion |
| title_fullStr | C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion |
| title_full_unstemmed | C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion |
| title_short | C2 pedicle screw placement on 3D-printed models for the performance assessment of CTA-based screw preclusion |
| title_sort | c2 pedicle screw placement on 3d printed models for the performance assessment of cta based screw preclusion |
| topic | C2 pediculoisthmic component 3-D printing C2 pedicle screw Multiplanar reconstruction High-riding vertebral artery |
| url | https://doi.org/10.1186/s13018-023-03498-x |
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