Development of a Patient-specific Guide for High Cervical Spine Fixation.

ABSTRACT

OBJECTIVE: High cervical spine fixation represents a challenge for spine surgeons due to the complex anatomy and the risks of vascular and medullar injury. The recent advances in 3-D printing have unfolded a whole new range of options for these surgeons. METHODS: In the present study, a guide for the placement of the lateral mass screw in the C1 vertebra was developed using 3-D printing. Eight real-size models of the high cervical spine and their respective screw guides were built using computed tomography (CT) scan images. The guidewires were inserted with the help of the printed guides and then the models were analyzed with the help of CT scan images. RESULTS: All of the guidewires in the present study obtained a safe placement in the models, avoiding the superior and inferior articular surfaces, the vertebral foramen, and the vertebral artery. CONCLUSION: The present study demonstrated the efficiency of the guide, a reliable tool for aiding the insertion of guidewires for screws in lateral masses of the C1.