FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for surgical treatment of idiopathic spinal scoliosis using 3D model of the spine with guides for insertion of transpedicular screws. Method is implemented using 3D prototyping of the spinal model for insertion of transpedicular screws. In the preoperative period, the method of multilayer spiral computed tomography is used to visualize the affected bone anatomical structures of the reconstructed spine of the patient; the state of the surrounding soft tissues, vascular and nerve structures is assessed by magnetic resonance imaging. Results are stored to form DICOM files. Performing the formation of a solid STL demonstration 3D model of the spine with display of all affected bone anatomical structures and anomalies of the spine using manufactured demonstration 3D model of the spine for virtual planning of the stages of surgical correction of the scoliotically deformed spine of the patient with virtual determination of insertion points of transpedicular fixation screws in the process of the forthcoming correction of idiopathic scoliotic curvature with subsequent marking of these points. Fixation levels are determined from postural radiographs and 3D model of the spine, and K-wires are inserted into the marked points on the mock-up of the patient’s spine. After the anaesthesia is performed with the patient lying on his/her stomach, the skin is incised above the spinous processes of the vertebrae one level above and below the intended area of the metal implantation in the vertebra, followed by dissection of the subcutaneous fat and its own fascia with access to the spine. Transpedicular screws are implanted, the points of insertion of wires into 3D model of the spine and their angle of inclination relative to the rest of the bone landmarks and intraoperative bone structures are visually aligned. Cortical plate is perforated with an awl within a projection of a root of the arch and a primary opening is formed. It is followed by palpation with determination of the length of the transpedicular screws, making the thread for the transpedicular screws and carrying the transpedicular screws into the formed holes. Correct position of the transpedicular screws is controlled with visual use of previously made 3D model of the patient's spine with guides. Metal fixation rod of metal fixation is placed on the heads of the installed transpedicular screws from the concave side of the spine with its subsequent fixation with nuts. Derotation is performed using a metal fixation rod placed on the heads of the installed transpedicular screws on the convex side of the spine.
EFFECT: method provides improved correction by using 3D model of the spine with guides for inserting transpedicular screws.
1 cl, 12 dwg, 1 ex
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Authors
Dates
2024-10-21—Published
2024-05-15—Filed