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DOI: 10.1016/j.rbo.2017.09.011
Desenvolvimento de um guia paciente-específico para fixação de coluna cervical alta[*]
Article in several languages: português | EnglishPublication History
16 August 2017
05 September 2017
Publication Date:
01 March 2019 (online)
Resumo
Objetivos
A fixação de coluna cervical alta pode representar um desafio para os cirurgiões de coluna devido à anatomia complexa e aos riscos de lesão vascular e medular. Os recentes avanços com a tecnologia de impressão 3 D abriram um novo leque de opções para os cirurgiões.
Métodos
Desenvolveu-se um guia para a adaptação de parafusos de massa lateral em C1 com auxílio de impressão 3 D. Foram confeccionados oito modelos em tamanho real de coluna cervical alta e seus respectivos guias com base em tomografias computadorizadas. Os fios-guia foram introduzidos com o auxílio dos guias; os modelos foram analisados com auxílio de tomografia computadorizada.
Resultados
Todos os fios-guia avaliados no estudo apresentaram um trajeto seguro nos modelos, respeitaram as superfícies articulares superiores e inferiores, o canal vertebral e a artéria vertebral.
Conclusão
O estudo demonstrou que o guia tem boa eficácia, é uma ferramenta confiável para auxiliar a adaptação de fios-guia para parafusos em massas laterais de C1.
Palavras-chave
vértebras cervicais/patologia - vértebras cervicais/cirurgia - fraturas da coluna vertebral - fusão vertebral - impressão tridimensional* Trabalho desenvolvido no Hospital Universitário Cajuru, Curitiba, PR, Brasil. Publicado originalmente por Elsevier Editora Ltda. © 2018 Sociedade Brasileira de Ortopedia e Traumatologia.
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Referências
- 1 Swartz EE, Floyd RT, Cendoma M. Cervical spine functional anatomy and the biomechanics of injury due to compressive loading. J Athl Train 2005; 40 (03) 155-61
- 2 Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine 2000; 25 (08) 962-9
- 3 Mummaneni PV, Haid RW. Atlantoaxial fixation: overview of all techniques. Neurol India 2005; 53 (04) 408-15
- 4 Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 1994; 129 (1-2): 47-53
- 5 Goel A, Laheri V. Re: Harms J, Melcher P. Posterior C1-C2 fusion with polyaxial screw and rod fixation. (Spine 2001;26: 2467-71). Spine 2002; 27 (14) 1589-90
- 6 Schulz R, Macchiavello N, Fernández E, Carredano X, Garrido O, Diaz J. , et al. Harms C1-C2 instrumentation technique: anatomo-surgical guide. Spine 2011; 36 (12) 945-50
- 7 Currier BL, Maus TP, Eck JC, Larson DR, Yaszemski MJ. Relationship of the internal carotid artery to the anterior aspect of the C1 vertebra: implications for C1-C2 transarticular and C1 lateral mass fixation. Spine 2008; 33 (06) 635-9
- 8 Mettler Jr FA, Koenig TR, Wagner LK, Kelsey CA. Radiation injuries after fluoroscopic procedures. Semin Ultrasound CT MR 2002; 23 (05) 428-42
- 9 Amiot LP, Lang K, Putzier M, Zippel H, Labelle H. Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine. Spine 2000; 25 (05) 606-14
- 10 Wu AM, Shao ZX, Wang JS, Yang XD, Weng WQ, Wang XY. , et al. The accuracy of a method for printing three-dimensional spinal models. PLoS One 2015; 10 (04) e0124291
- 11 Yang M, Li C, Li Y, Zhao Y, Wei X, Zhang G. , et al. Application of 3D rapid prototyping technology in posterior corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients. Medicine (Baltimore) 2015; 94 (08) e582
- 12 Mizutani J, Matsubara T, Fukuoka M, Tanaka N, Iguchi H, Furuya A. , et al. Application of full-scale three-dimensional models in patients with rheumatoid cervical spine. Eur Spine J 2008; 17 (05) 644-9
- 13 Whatley BR, Kuo J, Shuai C, Damon BJ, Wen X. Fabrication of a biomimetic elastic intervertebral disk scaffold using additive manufacturing. Biofabrication 2011; 3 (01) 015004
- 14 Xu N, Wei F, Liu X, Jiang L, Cai H, Li Z. , et al. Reconstruction of the upper cervical spine using a personalized 3D-printed vertebral body in an adolescent with Ewing sarcoma. Spine 2016; 41 (01) E50-4
- 15 Wu AM, Wang S, Weng WQ, Shao ZX, Yang XD, Wang JS. , et al. The radiological feature of anterior occiput-to-axis screw fixation as it guides the screw trajectory on 3D printed models: a feasibility study on 3D images and 3D printed models. Medicine (Baltimore) 2014; 93 (28) e242
- 16 Fu M, Lin L, Kong X, Zhao W, Tang L, Li J. , et al. Construction and accuracy assessment of patient-specific biocompatible drill template for cervical anterior transpedicular screw (ATPS) insertion: an in vitro study. PLoS One 2013; 8 (01) e53580
- 17 Sugawara T, Higashiyama N, Kaneyama S, Takabatake M, Watanabe N, Uchida F. , et al. Multistep pedicle screw insertion procedure with patient-specific lamina fit-and-lock templates for the thoracic spine: clinical article. J Neurosurg Spine 2013; 19 (02) 185-90
- 18 Wang MY, Samudrala S. Cadaveric morphometric analysis for atlantal lateral mass screw placement. Neurosurgery 2004; 54 (06) 1436-9 , discussion 1439–40
- 19 Ma XY, Yin QS, Wu ZH, Xia H, Liu JF, Zhong SZ. Anatomic considerations for the pedicle screw placement in the first cervical vertebra. Spine 2005; 30 (13) 1519-23
- 20 Christensen DM, Eastlack RK, Lynch JJ, Yaszemski MJ, Currier BL. C1 anatomy and dimensions relative to lateral mass screw placement. Spine 2007; 32 (08) 844-8