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Title:Uporaba vodilnih šablon, izdelanih s tehnologijo hitre izdelave prototipov pri vstavitvi pedikularnih vijakov
Authors:ID Merc, Matjaž (Author)
ID Drstvenšek, Igor (Author)
ID Vogrin, Matjaž (Author)
ID Brajlih, Tomaž (Author)
ID Rečnik, Gregor (Author)
Files:.pdf Zdravniski_vestnik_2013_Merc_et_al._Uporaba_vodilnih_sablon,_izdelanih_s_tehnologijo_hitre_izdelave_prototipov_pri_vstavitvi_pedikularni.pdf (219,77 KB)
MD5: 09710DB79FAA14011D0F7F987A4C3253
 
URL http://vestnik.szd.si/index.php/ZdravVest/article/view/649
 
Language:Slovenian
Work type:Scientific work
Typology:1.01 - Original Scientific Article
Organization:FS - Faculty of Mechanical Engineering
Abstract:Izhodišča: Postavitev pedikularnih vijakov s prostoročno tehniko je povezana z znatnim odstotkom predrtja pedikla. To tveganje lahko zmanjšamo z uporabo medoperativne diaskopije ali z navigacijo, ki imata določene pomembne pomanjkljivosti. Obetaven princip, s katerim bi lahko odpravili večino težav, je metoda hitre izdelave prototipov, s katero lahko izdelamo bolniku prilagojene vodilne šablone, ki omogočajo optimalno pozicioniranje vijakov. V zadnjem desetletju je bilo izvedenih nekaj študij, v katerih so predvsem na kadavrih z uporabo šablon relativno uspešno vsadili pedikularne vijake. Pri nas smo izvedli klinično študijo in izdelali šablone, ki omogočajo hkratno vsaditev vijakov na več ravneh. V raziskavo smo prvič vključili tudi križnično hrbtenico. Metode: V prospektivno klinično raziskavo primerov s kontrolami je bilo vključenih 15 oseb. V ledveno in križnično hrbtenico smo vstavili 30 pedikularnih vijakov z uporabo vodilnih šablon, 36 vijakov pa smo vstavili prostoročno pod nadzorom RTG. Na podlagi preoperativnih CT-posnetkov smo s postopkom selektivnega laserskega sintranja izdelali vodilne šablone. V obeh skupinah smo opravili analizo predrtja pediklov glede na pooperativni izvid CT. Rezultati: Incidenca predrtja pedikla je pri uporabi vodilne šablone statistično značilno manjša kot pri kontroli. Zaključki: Uporaba večnivojskih vodilnih šablon se je izkazala kot zanesljiva metoda, ki pomembno zmanjša verjetnost za poškodbo pedikla in s tem povezane zaplete. Kljub temu ima določene pomanjkljivosti, ki so povezane z relativno dolgim časom izdelave vodilnih šablon, z napakami pri izdelavi ali s pozicioniranjem med operacijo. Zaradi omenjenih lastnosti metoda ni nadomestila prostoročne tehnike ali navigacije, vendar je pomembna alternativa v izbranih primerih.
Keywords:model, pedikel, vretence, navigacija, prostoročna tehnika
Publication status:Published
Publication version:Version of Record
Year of publishing:2013
Number of pages:str. 395-401
Numbering:Letn. 82, št. 6
PID:20.500.12556/DKUM-56839 New window
ISSN:1318-0347
UDC:617.3
ISSN on article:1318-0347
COBISS.SI-ID:4706367 New window
NUK URN:URN:SI:UM:DK:XY00NE7M
Publication date in DKUM:30.12.2015
Views:1304
Downloads:101
Metadata:XML DC-XML DC-RDF
Categories:Misc.
:
MERC, Matjaž, DRSTVENŠEK, Igor, VOGRIN, Matjaž, BRAJLIH, Tomaž and REČNIK, Gregor, 2013, Uporaba vodilnih šablon, izdelanih s tehnologijo hitre izdelave prototipov pri vstavitvi pedikularnih vijakov. Zdravniški vestnik. glasilo Slovenskega zdravniškega društva [online]. 2013. Vol. 82, no. 6, p. 395–401. [Accessed 7 April 2025]. Retrieved from: https://dk.um.si/IzpisGradiva.php?lang=eng&id=56839
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Record is a part of a journal

Title:Zdravniški vestnik. glasilo Slovenskega zdravniškega društva
Publisher:Slovensko zdravniško društvo
ISSN:1318-0347
COBISS.SI-ID:32893696 New window

Licences

License:CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
Link:http://creativecommons.org/licenses/by-nc/4.0/
Description:A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.
Licensing start date:30.12.2015

Secondary language

Language:English
Title:Use of rapid prototyping drill guide template for pedicle screw placement
Abstract:Background: Pedicle screw placement using free hand technique has high incidence of pedicle perforation. The said risk can be reduced with intra-operative fluoroscopy or navigation, which have some disadvantages. A promising principle for solving most of the issues is the rapid prototyping technology. By this technique it is possible to manufacture patient specific drill guide templates that enable optimal pedicle screw placement. In the last decade, many studies have featured relatively successful implantations of pedicle screws through the use of drill guide templates, though mostly on cadavers. We performed a similar clinical study involving the manufacture of templates for the lumbar and sacral regions that enable simultaneous multiple-level screw implanting. Methods: A randomized clinical trial was performed in 15 patients. In the lumbar and sacral spine 30 screws were implanted using drill guide template and 36 screws using free hand technique under fluoroscopy supervision. Preoperative CT-scans were taken for drill guide template design and manufacture using selective laser sintering method. According to postoperative CT-scan analysis, pedicle perforation incidence was estimated. Results: The incidence of cortex perforation was significantly reduced in the drill guide template group. Conclusions: Drill guide templates have turned out to be a reliable solution that importantly reduces pedicle perforation incidence and complications related to it. However, there are shortcomings: a relatively lengthy manufacturing process, possible manufacturing faults and incorrect positioning during the operation. Owing to mentioned disadvantages, templates have not replaced free hand and navigation technique yet, but could represent a useful tool in some selected cases.
Keywords:model, pedicle, vertebra, navigation, free-hand technique


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