Image-Based Planning and Validation of C1-C2 Transarticular Screw Fixation Using Personalized Drill Guides

Objective: Posterior transarticular spine fusion is a surgical procedure used to stabilize the cervical bodies C1 and C2. Currently, spine screws are used most frequently, according to the procedure of Magerl. As the anatomy is rather complex and the view is limited, this procedure has a high risk factor. We present and validate a planning system for cervical screw insertion based on preoperative CT imaging.Materials and Methods: The planning system discussed allowed a neurosurgeon to interactively determine the desired position of the cervical screws, based on appropriate and real-time reslices through the preoperative CT image volume. From the planning, a personalized mechanical drill guide was derived as a means of transferring the plan intraoperatively. Eight cadaver experiments were performed to validate this approach. Postoperative CT was applied, and screw locations were extracted from the postoperative images after registering them to preoperative images. In this way, the deviations of the axes of...

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