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Development of a Cervical SpineGuide for the treatment of severe cervical scoliosis. Based on two pediatric severe cervical scoliosis cases

Mol, J.J.H. (2019) Development of a Cervical SpineGuide for the treatment of severe cervical scoliosis. Based on two pediatric severe cervical scoliosis cases.

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Embargo date:4 March 2022
Abstract:Introduction: The treatment of complex cervical scoliosis with pedicle screws in children is challenging due to multiple reasons. The small anatomical dimen- sions and the rarity of the disorder influence the difficulty of the treatment. The last decade a new personalized technique has been introduced due to the advent of 3D printing, the SpineGuide. A personalized drill guide developed to fit on thoracic and lumbar vertebrae. However, a Cervical SpineGuide (CSG) is needed to improve the treatment of severe cervical scoliosis. Method: An assembly design for the SpineGuide has been developed to be able to gain a stable fit on the laminae of the cervical vertebrae. To achieve this, multi- ple assembly designs were investigated and tested by several orthopedic spine sur- geons. The best design is further tested in an experiment on the cervical vertebrae of a cadaveric specimen (74yr - ⇡). Furthermore, a pediatric patient (4yr - ⇢) with severe cervical scoliosis is treated with the tested CSG. In both cases, cadaver exper- iment and case study, the entry point deviation and angle deviation of the drilled holes were examined. Results: The assembly design of the CSG consists of three 3D-printed compo- nents that proved the most stable fit on the cervical vertebrae. Unanimously, the or- thopedic spine surgeons scored this design to have the most stable fit. The cadaver experiment: an entry point deviation of 0.98 ± 0.38mm and an angle deviation of 1.75 ± 0.62°. The case study: an average entry point deviation of 1.20 ± 0.40mm and an angle deviation of 16.59 ± 0.62°. Conclusion: The assembly design of the CSG is found adequate to be used in the treatment of severe cervical scoliosis in pediatric patients. The CSG has a stable fit on the laminae of the cadaver and also the case study vertebrae. The precision of the CSG in the case study is high in comparison with earlier research. The accuracy, however, shows a larger deviation. The influence of the anatomy on the direction of the pedicle screw most probably explains this larger deviation. Future clinical re- search will expand the sample size and thereby the statistical weight of the accuracy and precision of the CSG.
Item Type:Essay (Master)
Clients:
UMC Utrecht, Utrecht, Netherlands
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/77861
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