Bone graft translation of four upper cervical spine fixation techniques in a cadaveric model

Purpose of study: to summarize the experience in three-dimensional biomodeling and custom made metal constructions for surgical treatment of spinal deformities of different localization and etiology, evaluate its advantages, potentialities and efficacy. Patients and methods. During the period from 2011 to 2018 three-dimensional (3D) custom-made spinal models were used in 52 patients with different spinal deformities: congenital multilevel spinal deformity (n=20), upper cervical spine deformities (n=12), III-IV degree of spondylolisthesis (n=10), neurogenic scoliosis (n=8), neurofibromatosis (n=2). 3D models were created in scale 1:1 by stereolithographic technique on the basis of computer model designed by spiral CT results. In all cases 3D models were used for preoperative planning including the intended deformity correction, decompression and spine fixation. In 26 cases 3D spinal models were used to manufacture the custom made metal constructions for the deformity correction and spine fixation: plates for the upper cervical spine anterior fixation, cervicothoracic junction, plates and cages for lumbosacral fixation, and implants for spinopelvic fixation. Results. In all cases the use of spine bio models enabled to achieve important additional information at preoperative planning and intraoperatively. Long-term follow up made up 3 years. After neural structures decompression and deformity correction good clinical and roentgenologic results were observed in all patients. Use of custom made implants ensured stable spine fixation in all cases with the exception of 3 patients in whom the implants were removed due to infectious complication (n=1) and poor postoperative wood healing. Conclusion. In deformities of different etiology the full-scale spine models provide better assessment of the deformity pattern and preoperative planning. 3D models and computer modeling make possible the manufacture of individual metal constructions for spine fixation that is especially topical in severe deformities.

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Biomechanical Comparison of the Dewar and Interspinous Cervical Spine Fixation Techniques

Spine ◽

10.1097/00007632-199602010-00007 ◽

1996 ◽

Vol 21 (3) ◽

pp. 295-298 ◽

Cited By ~ 6

Author(s):

Edward D. Simmons ◽

Thomas G. Burke ◽

Timothy Haley ◽

John Medige

Keyword(s):

Cervical Spine ◽

Fixation Techniques ◽

Biomechanical Comparison ◽

Spine Fixation ◽

Cervical Spine Fixation

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Neurological outcome and postoperative stability after anterior cervical spine fixation by the use of cervical spine locking plate

International Surgery Journal ◽

10.18203/2349-2902.isj20175390 ◽

2017 ◽

Vol 4 (12) ◽

pp. 3805

Author(s):

Ch Ali Manzoor ◽

Muhammad Irshad ◽

Muhammad Aamir

Keyword(s):

Cervical Spine ◽

Standard Deviation ◽

Neurological Outcome ◽

Locking Plate ◽

Fracture Dislocation ◽

Upper Cervical Spine ◽

Lower Cervical Spine ◽

Cord Injury ◽

Spine Fixation ◽

Cervical Spine Fixation

Background: The fractures of cervical spine are divided into upper cervical spine (C1-C2) and lower cervical spine (C3-C7) also called sub axial cervical spine. Sub axial cervical injuries are common, ranging in severity from minor ligamentous strain or spinous process fracture to complete fracture dislocation with bone and ligament disruption, resulting in severe spinal cord injury. The objective of this study was to determine the neurological outcome and postoperative stability after anterior cervical spine fixation by the use of cervical spine locking plate (CSLP) attached with cancellous screws.Methods: This descriptive study was carried out in the Department of Neurosurgery, Nishtar Hospital, Multan, Pakistan. One hundred and fifteen patients fulfilled the inclusion criteria were selected. Patient of either gender more than 15 years of age and less than 60 years of age having unstable lower cervical spine injuries from C-3 to C 7 on X-ray underwent anterior cervical fixation.Results: Age range from 15 to 60 years with mean 32.34±standard deviation (SD) =12.06. The mean Frankel grading of the patients was 3.26±standard deviation (SD) =1.33. There were 97 (84.3%) male patients and 18 (15.7%) female patients. The neurological outcome was good in 107(89.6%) patients and poor in 12 (10.4%). The postoperative stability was YES in 109 (94.8%) patients and NO in 06 (5.2%). In the mode of injury there were 65 (56.5%) patients having road traffic accident, 41 (35.7%) patients having fall from tree/roof/stairs, 6 (65.2%) patients having fall of brick on the patient, 1 (0.9%) patient having Buffalo hit/animal contact, 2 (1.7%) patient having contact of head at floor of swimming pool after jumped in.Conclusions: It is concluded from this study that good results were achieved with the use of the CSLP. The use of anterior approach in treatment of the injured lower spine is safe and effective.

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Endonasal Surgery of the Upper Cervical Spine: A Morphometric Analysis

Skull Base ◽

10.1055/s-2008-1093170 ◽

2008 ◽

Vol 18 (S 01) ◽

Author(s):

Harminder Singh ◽

Bartosz Grobelny ◽

Adam Flanders ◽

Marc Rosen ◽

Paul Schiffmacher ◽

...

Keyword(s):

Cervical Spine ◽

Morphometric Analysis ◽

Upper Cervical Spine ◽

Endonasal Surgery ◽

Upper Cervical

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Defining the Nasopalatine Line: Anatomic Limitations for Endoscopic Endonasal Surgery of the Odontoid Process and Upper Cervical Spine

Skull Base ◽

10.1055/s-2008-1093252 ◽

2008 ◽

Vol 18 (S 01) ◽

Author(s):

John de Almeida ◽

Adam Zanation ◽

Ricardo Carrau ◽

Amin Kassam ◽

Carl Snyderman

Keyword(s):

Cervical Spine ◽

Odontoid Process ◽

Upper Cervical Spine ◽

Endoscopic Endonasal Surgery ◽

Endonasal Surgery ◽

Endoscopic Endonasal ◽

Upper Cervical

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A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

Pediatric Neurosurgery ◽

10.1159/000514248 ◽

2021 ◽

pp. 1-7

Author(s):

Marko Jug

Keyword(s):

Cervical Spine ◽

3D Model ◽

Intraoperative Complications ◽

Tumor Resection ◽

Upper Cervical Spine ◽

Spine Instrumentation ◽

Cord Injury ◽

Spinal Navigation ◽

Upper Cervical ◽

3D Printed

Introduction: In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. Case Presentation: We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. Discussion/Conclusion: Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

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