Design of digitized anterior approach screw fixation program: Clinical
application in the treatment of type Ⅱ odontoid fractures

doi:10.3969/j.issn.2095-4344.2013.26.024

Abstract

Abstract:

BACKGROUND: The treatment of type Ⅱ odontoid fractures has the difficulties of difficult, high risk and the choice between cervical spine stability and cervical activity.
OBJECTIVE: To investigate the method and clinical application of computer in the three-dimensional construction of type Ⅱ odontoid fractures, reduction and design of digitized fixation.
METHODS: One cervical specimen was used to prepare the type Ⅱ odontoid fractures model for high-speed thin CT scan. The model was reconstructed and reseted in the Mimics. The Solidworks was used to design the screw and performed virtual simulation on the three-dimensional model of fracture reduction in order to guide the clinical application.
RESULTS AND CONCLUSION: Three-dimensional reconstruction and reduction were performed on the fracture model, and the virtual screw fixation was completed according to the three-dimensional measurement data thus guiding the clinical surgery successfully. The results show that digitized screw fixation that used in the treatment of type Ⅱ odontoid fractures can be designed on the computer with Mimics and Solidworks, which has good reference value to the clinical surgery.

Key words: bone and joint implants, academic discussion of bone and joint, type Ⅱ odontoid fracture, digital design, three-dimensional reconstruction, screws, internal fixation, biomechanics

CLC Number:

R318

Chen Xuan-huang, Zhang Guo-dong, Wu Chang-fu, Lin Hai-bin. Design of digitized anterior approach screw fixation program: Clinical
application in the treatment of type Ⅱ odontoid fractures[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.26.024.

Figures/Tables 5

References

[1] White AP,Hashimoto R,Norvell DC,et al.Morbidity and mortality related to odontoid fracture surgery in the elderly population.Spine.2010;35(9):146-157.

[2] Reynier Y,Lena G,Diaz-Vazquez P,et al.Evaluation of 138 fractures of the cervical spine during a recent 5-year period (1979 to 1983). Therapeutic approaches.Neurochirurgie. 1985;31(2):153-160.

[3] 曹正霖,钟世镇,徐达传.寰枢椎的解剖学测量及其临床意义[J].中国临床解剖学杂志,2000,18(4):299-301.

[4] 郝定均,贺宝荣,许正伟,等.寰椎“椎弓根”三维CT重建测量及分型的临床意义[J].中国脊柱脊髓杂志,2012,22(2):142-146.

[5] 林锋,池永龙,许崇永,等.国人寰枢椎影像解剖测量及其临床意义[J].温州医学院学报,2004,34(4):304-305.

[6] Müller EJ,Wick M,Russe O,et al.Management of odontoid fractures in the elderly.Eur Spine J.1999;8(5):360-365.

[7] Pryputniewicz DM,Hadley MN.Axis fractures.Neurosurgery. 2010;66(3):68-82.

[8] Anderson LD,D'Alonzo RT.Fractures of the odontoid process of the axis.J Bone Joint Surg Am.1974;56(8): 1663-1674.

[9] Böhler J.Screw-osteosynthesis of fractures of the dens axis (author's transl)].Unfallheilkunde.1981;84(6):221-223.

[10] Rajasekaran S,Kamath V,Avadhani A.Odontoid anterior screw fixation.Eur Spine J.2010;19(2):339-340.

[11] 中国知网.中国学术期刊总库[DB/OL].2013-02-10. https://www.cnki.net

[12] SCI数据库.Web of Sciencevia ISI Web of Knowledge[DB/OL]. 2013-02-10.http://ip-science.thomsonreuters.com/mjl

[13] Aebi M,Etter C,Coscia M.Fractures of the odontoid process. Treatment with anterior screw fixation.Spine.1989;14(10): 1065-1070.

[14] Morandi X,Hanna A,Hamlat A,et al.Anterior screw fixation of odontoid fractures.Surg Neurol.1999;51(3):236-240.

[15] Chang KW,Liu YW,Cheng PG,et al.One Herbert double-threaded compression screw fixation of displaced type II odontoid fractures.J Spinal Disord.1994;7(1):62-69.

[16] Rainov NG,Heidecke V,Burkert W.Direct anterior fixation of odontoid fractures with a hollow spreading screw system.Acta Neurochir.1996;138(2):146-153.

[17] Kazan S,Tuncer R,Sindel M.Percutaneous anterior odontoid screw fixation technique. A new instrument and a cadaveric study.Acta Neurochir.1999;141(5):521-524.

[18] Horgan MA,Hsu FP,Frank EH.A novel endoscopic approach to anterior odontoid screw fixation: technical note.Minim Invasive Neurosurg.1999;42(3):142-145.

[19] Sherburn EW,Day RA,Kaufman BA,et al.Subdental synchondrosis fracture in children: the value of 3-dimensional computerized tomography.Pediatr Neurosurg.1996;25(5): 256-259.

[20] Geusens E,Pans S,Brys P,et al.The axis ring: a forgotten semiologic sign in the detection of low odontoid fractures. JBR-BTR.2002;85(5):241-245.

[21] 池永龙.经皮上颈椎螺钉内固定手术的并发症及其防范措施[J].中国脊柱脊髓杂志,2008,18(5):327-328.

[22] 倪斌,陶春生,郭翔,等.双侧寰椎椎板钩及枢椎椎弓根内固定在寰枢椎融合术中的初步应用[J].脊柱外科杂志,2007,5(3):129-131.

[23] 杨双石,刘景发,吴增晖,等.齿状突Ⅱ型骨折加压螺丝钉内固定的实验和临床研究[J].中华创伤杂志,2000,16(1):20-22.

[24] 谭明生,唐向盛,王文军,等.寰枢椎椎弓根螺钉内固定术治疗儿童寰枢椎脱位的初步报告[J].中国脊柱脊髓杂志,2012,22(2): 131-136.

[25] 王超,闫明,周海涛,等.前路松解复位后路内固定治疗难复性寰枢关节脱位[J].中国脊柱脊髓杂志,2003,13(10):583-586.

[26] Hanigan WC,Powell FC,Elwood PW,et al.Odontoid fractures in elderly patients.J Neurosurg.1993;78(1):32-35.

[27] Frangen TM,Zilkens C,Muhr G,et al.Odontoid fractures in the elderly: dorsal C1/C2 fusion is superior to halo-vest immobilization.J Trauma.2007;63(1):83-89.

[28] 刘登均,贺小兵,王明贵,等.Mimics软件在腰椎转移性肿瘤治疗前评估中的应用[J].中国数字医学,2011,6(1):102-105.

[29] Klein S,Whyne CM,Rush R,et al.CT-based patient-specific simulation software for pedicle screw insertion.J Spinal Disord Tech.2009;22(7):502-506.

[30] Song KJ,Lee KB,Kim KN.Treatment of odontoid fractures with single anterior screw fixation.J Clin Neurosci.2007;14(9): 824-830.

[31] Agrillo A,Russo N,Marotta N,et al.Treatment of remote type ii axis fractures in the elderly: feasibility of anterior odontoid screw fixation.Neurosurgery.2008;63(6):1145-1150.

[32] Platzer P,Thalhammer G,Ostermann R,et al.Anterior screw fixation of odontoid fractures comparing younger and elderly patients.Spine.2007;32(16):1714-1720.

[33] Tun K,Kaptanoglu E,Cemil B,et al.Anatomical study of axis for odontoid screw thickness, length, and angle.Eur Spine J. 2009;18(2):271-275.

[34] Platzer P,Eipeldauer S,Vécsei V.Odontoid plate fixation without C1-C2 arthrodesis: biomechanical testing of a novel surgical technique and comparison to the conventional screw fixation procedure.Clin Biomech.2010;25(7):623-627.

[35] Yamazaki M,Okawa A,Kadota R,et al.Surgical simulation of circumferential osteotomy and correction of cervico-thoracic kyphoscoliosis for an irreducible old C6-C7 fracture dislocation.Acta Neurochir.2009;151(7):867-872.

[36] Rajasekaran S,Vidyadhara S,Ramesh P,et al.Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries.Spine.2007;32(2):56-64.

[37] Blemker SS,Asakawa DS,Gold GE,et al.Image-based musculoskeletal modeling: applications, advances, and future opportunities.J Magn Reson Imaging.2007;25(2):441-451.

[38] Aurouer N,Obeid I,Gille O,et al.Computerized preoperative planning for correction of sagittal deformity of the spine.Surg Radiol Anat.2009;31(10):781-792.

[39] Klein S,Whyne CM,Rush R,et al.CT-based patient-specific simulation software for pedicle screw insertion.J Spinal Disord Tech.2009;22(7):502-506.