Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jul-Sep;9(3):226-229.
doi: 10.1016/j.jcot.2018.07.010. Epub 2018 Jul 17.

Cervical pedicle screw guiding jig, an innovative solution

Abhishek Kashyap  1 , Shreesh Kadur  2 , Abhishek Mishra  2 , Gaurang Agarwal  2 , Abhay Meena  2 , Lalit Maini  1
Affiliations
Review

Cervical pedicle screw guiding jig, an innovative solution

Abhishek Kashyap et al. J Clin Orthop Trauma. 2018 Jul-Sep.

Erratum in

Abstract

Pedicle screws are one the commonest used modality in spinal instrumentation. However, the method of pedicle screw fixation in cervical spine as compared to thoracic and lumbar spine is still technically demanding because it carries the risk of catastrophic damage to the surrounding neurovascular structures We have utilized virtual planning and 3D (3-dimension) printing to develop a patient specific jig to guide the accurate placement of pedicle screws. A patient with bifacetal dislocation C7 over D1 classified as flexion-distraction injury type 3 who was planned for decompression and fusion by posterior instrumentation at C6, C7, D1 and D2 was selected. A CT scan with 1 mm cuts was used to produce DICOM images of the same. Using these DICOM images virtual planning was done on MIMICS and 3 MATICS software to create patient specific jigs. These jigs were then 3D printed using a 3D printer and used for accurate placement of pedicle screws intra-operatively after adequate sterilization. Our procedure is low cost but high technology based. It is simple, accurate, and very cost effective. The technology transfer is very easy and can be adopted easily.

Keywords: 3d printing; Cervical spine; Jig; Pedicle screw.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
3D RECON and sagittal view of CT scan with arrows showing bifacetal dislocation of C7 over D1.
Fig. 2
Fig. 2
Showing guiding cylinders for pedicle screw trajectory, anticipated jig model placed over posterior elements of the spine and the 3d model of the jig.
Fig. 3
Fig. 3
Showing jigs being tested with guide wires.
Fig. 4
Fig. 4
Intra-operative placement of jigs over the corresponding vertebra.
Fig. 5
Fig. 5
Post-operative axial CT image showing type 0 breech in C6 vertebra.
Fig. 6
Fig. 6
Post-operative axial CT image showing type 0 breech in C7 vertebra.
Fig. 7
Fig. 7
Post-operative sagittal CT image showing pedicle screw in C6 and C7.
See this image and copyright information in PMC

References

    1. Panjabi M.M., Shin E.K., Chen N.C., Wang J.L. Internal morphology of human cervical pedicles. Spine. 2000 May 15;25(10):1197–1205. - PubMed
    1. Ebraheim N.A., Xu R., Knight T., Yeasting R.A. Morphometric evaluation of lower cervical pedicle and its projection. Spine. 1997 Jan 1;22(1):1–5. - PubMed
    1. Anon . American Spine Injury Association; Atlanta, GA: 2008. International Standards for Neurological Classification of Spinal Injury.
    1. Hoppenfield S., Boer P.D., Buckley R. fifth ed. Lippincott Williams and Wilkins; New York, NY: 2017. Surgical Exposures in Orthopaedics: the Anatomic Approach; pp. 715–738. (chapter 6)
    1. Raley D.A., Mobbs R.J. Retrospective computed tomography scan analysis of percutaneously inserted pedicle screws for posterior transpedicular stabilization of the thoracic and lumbar spine: accuracy and complication rates. Spine. 2012 May 20;37(12):1092–1100. - PubMed