SECOND MEASUREMENT OF THREE-DIMENSIONAL CT RECONSTRUCTION DATA FOR SCOLIOSIS ORTHOPAEDIC SURGERY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIN Guoxin ¹ , GUO Wenli ² , LI Lei ¹ , CUI Shaoqian ¹ , DUAN Jingzhu ¹ , WANG Huan. ¹

1Department of Orthopedic Surgery, 2Department of Radiology, the Shengjing Affiliated Hospital, China Medical University, Shenyang Liaoning, 110004, P.R.China;

Corresponding author：

Keywords：

Scoliosis; Orthopedic surgery; Three-dimensional CT reconstruction; Pedicle screw

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【Abstract】 Objective To explore the clinical application and outcomes of preoperative second measurement of three-dimensional (3-D) CT reconstruction data for scoliosis orthopedic surgery. Methods Between August 2006 and March 2008, 11 patients with severe rigid scoliosis received surgery treatment, including 4 males and 7 females with an average age of 17.2 years (range, 15-19 years). Preoperative second measurement of 3-D CT reconstruction data was conducted to guide the surgery， including the angle and width of pedicle, the entry point, and the choice of screws whose lengths and diameters were suitable. A total of 197 pedicle screws were implanted. The operation time， blood loss， postoperative nerve function，and Cobb’s angles at sagittal and coronal view were all recorded， and the postoperative CT scan was performed to assess the accuracy of pedicle screw insertion according to Andrew classification. Results Pedicle screws were implanted within 1-11 minutes (mean, 5.8 minutes), and the blood loss was 450-2 300 mL (mean, 1 520 mL). The postoperative X-ray films showed the correction rates of Cobb’s angle were 68.5% in coronal view and 55.5% in sagittal view. The accuracy of pedicle screw insertion was rated as grade I in 77 screws (39.1%)，grade II in 116 screws (58.9%)， and grade III in 4 screws (2.0%) according to postoperative CT scan. All 11 cases were followed up 14 months to 2 years without any complications. Conclusion　Preoperative second measurement of 3-D CT reconstruction data can make the surgery process easy and accurate in treatment of severe scoliosis.

Citation： JIN Guoxin,GUO Wenli,LI Lei,CUI Shaoqian,DUAN Jingzhu,WANG Huan.. SECOND MEASUREMENT OF THREE-DIMENSIONAL CT RECONSTRUCTION DATA FOR SCOLIOSIS ORTHOPAEDIC SURGERY. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(1): 74-77. doi: Copy

1.	in the thoracic spine: is it safe? Spine (Phila Pa 1976), 2004, 29(3): 333-342.
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9.	Max Aebi. AO脊柱手册——原理与技巧. 陈仲强, 袁文, 主译. 济南: 山东科学技术出版社, 2010: 210-285.
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14.	Vaccaro AR, Rizzolo SJ, Balderston RA, et al. Placement of pedicl screws in the thoracic spine. Part II: An anatomicaland radiographi assessment.
15.	Rampersand YR, Pile JH, Salonen D, et al. Clinical accuracy of fluoroscopic.
16.	Xu R, Ebraheim NA, Ou Y, et al. Anatomic considerations of pedicle screw placement in the thoracic spine. Roy-Camille technique versus open-lamina technique. Spine (Phila Pa 1976), 1998, 23(9): 1065-1068.
17.	Di Silvestre M, Parisini P, Lolli F, et al. Complications of thoracic pedicle.
18.	Youkilis AS, Quint DJ, McGillicuddy JE, et al. Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery, 2001, 48(4): 771-778.
19.	Merloz P, Tonetti J, Pittet L, et al. Pedicle screw placement using image guided techniques. Clin Orthop Relat Res, 1998, (354): 39-48.
20.	Amiot LP, Lang K, Putzier T, et al. Comparative results between conventional.
21.	Amiot LP, Poulin F. Computed tomography-based navigation for hip, knee, and spine surgery. Clin Orthop Relat Res, 2004, (421): 77-86.
22.	Holly LT, Foley KT. Percutaneous placement of posterior cervical screws using three-dimensional fluoroscopy. Spine (Phila Pa 1976), 2006, 31(5): 536-541.
23.	Mao K, Wang Y, Xiao S, et al. Clinical application of computer-designed polystyrene models in complex severe spinal deformities: a pilot study. Eur Spine J, 2010, 19(5): 797-802.
24.	陈玉兵, 陆声, 徐永清, 等. 快速成型个体化导航模板辅助胸椎椎弓根螺钉置入可行性研究. 中国矫形外科杂志, 2009, 17(20): 1557-1561.
25.	Abul-Kasim K, Ohlin A, Strömbeck A, et al. Radiological and clinical outcome of screw placement in adolescent idiopathic scoliosis: evaluation with low-dose computed tomography. Eur Spine J, 2010, 19(1): 96-104.
26.	Gstoettner M, Lechner R, Glodny B, et al. Inter- and intraobserver reliability assessment of computed tomographic 3D measurement of pedicles in scoliosis and size matching with pedicle screws. Eur Spine J, 2011, 20(10): 1771-1779.
27.	Su P, Zhang W, Peng Y, et al. Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis. Eur Spine J, 2011. [Epub ahead of print].

1. in the thoracic spine: is it safe? Spine (Phila Pa 1976), 2004, 29(3): 333-342.
2. Confirmation of an image-based technique for screw placement. Spine (Phila Pa 1976), 1993, 18(13): 1856-1861.
3. J Bone Joint Surg (Am), 1995, 77(8): 1200-1206.
4. computer assisted pedicle screw fixation: a CT analysis. Spine (Phila Pa 1976), 2005, 30(7): 183-190.
5. screws in scoliosis treatment. Spine (Phila Pa 1976), 2007, 32(15): 1655-1661.
6. and computer-assisted pedicle screw installation in the thoracic,.
7. lumbar and sacral spine. Spine (Phila Pa 1976), 2000, 25(5): 606-614.
8. Roy-Camille R, Saillant G, Mazel C. Internal fixation of the lumbar spine with pedicle screw plating. Clin Orthop Relat Res, 1986, (203): 7-17.
9. Max Aebi. AO脊柱手册——原理与技巧. 陈仲强, 袁文, 主译. 济南: 山东科学技术出版社, 2010: 210-285.
10. Rogala EJ, Drummond DS, Gurr J. Scoliosis: incidence and natural history. A prospective epidemiological study. J Bone Joint Surg (Am), 1978, 60(2): 173-176.
11. Kim YJ, Lenke LG, Birdwell KH, et al. Free hand pedicle screw placement.
12. Youkilis AS, Quint DJ, McGillicuddy JE, et al. Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery, 2001, 48(4): 771-779.
13. Steinmann JC, Herkowitz HN, el-Kommos H, et al. Spinal pedicl fixation.
14. Vaccaro AR, Rizzolo SJ, Balderston RA, et al. Placement of pedicl screws in the thoracic spine. Part II: An anatomicaland radiographi assessment.
15. Rampersand YR, Pile JH, Salonen D, et al. Clinical accuracy of fluoroscopic.
16. Xu R, Ebraheim NA, Ou Y, et al. Anatomic considerations of pedicle screw placement in the thoracic spine. Roy-Camille technique versus open-lamina technique. Spine (Phila Pa 1976), 1998, 23(9): 1065-1068.
17. Di Silvestre M, Parisini P, Lolli F, et al. Complications of thoracic pedicle.
18. Youkilis AS, Quint DJ, McGillicuddy JE, et al. Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery, 2001, 48(4): 771-778.
19. Merloz P, Tonetti J, Pittet L, et al. Pedicle screw placement using image guided techniques. Clin Orthop Relat Res, 1998, (354): 39-48.
20. Amiot LP, Lang K, Putzier T, et al. Comparative results between conventional.
21. Amiot LP, Poulin F. Computed tomography-based navigation for hip, knee, and spine surgery. Clin Orthop Relat Res, 2004, (421): 77-86.
22. Holly LT, Foley KT. Percutaneous placement of posterior cervical screws using three-dimensional fluoroscopy. Spine (Phila Pa 1976), 2006, 31(5): 536-541.
23. Mao K, Wang Y, Xiao S, et al. Clinical application of computer-designed polystyrene models in complex severe spinal deformities: a pilot study. Eur Spine J, 2010, 19(5): 797-802.
24. 陈玉兵, 陆声, 徐永清, 等. 快速成型个体化导航模板辅助胸椎椎弓根螺钉置入可行性研究. 中国矫形外科杂志, 2009, 17(20): 1557-1561.
25. Abul-Kasim K, Ohlin A, Strömbeck A, et al. Radiological and clinical outcome of screw placement in adolescent idiopathic scoliosis: evaluation with low-dose computed tomography. Eur Spine J, 2010, 19(1): 96-104.
26. Gstoettner M, Lechner R, Glodny B, et al. Inter- and intraobserver reliability assessment of computed tomographic 3D measurement of pedicles in scoliosis and size matching with pedicle screws. Eur Spine J, 2011, 20(10): 1771-1779.
27. Su P, Zhang W, Peng Y, et al. Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis. Eur Spine J, 2011. [Epub ahead of print].

Chinese Journal of Reparative and Reconstructive Surgery

SECOND MEASUREMENT OF THREE-DIMENSIONAL CT RECONSTRUCTION DATA FOR SCOLIOSIS ORTHOPAEDIC SURGERY

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