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Statistical shape modelling of the thoracic spine for the development of pedicle screw insertion guides

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Title: Statistical shape modelling of the thoracic spine for the development of pedicle screw insertion guides
Authors: Wai, G
Rusli, W
Ghouse, S
Kieser, DC
Kedgley, A
Newell, N
Item Type: Journal Article
Abstract: Spinal fixation and fusion are surgical procedures undertaken to restore stability in the spine and restrict painful or degenerative motion. Malpositioning of pedicle screws during these procedures can result in major neurological and vascular damage. Patient-specific surgical guides offer clear benefits, reducing malposition rates by up to 25%. However, they suffer from long lead times and the manufacturing process is dependent on third-party specialists. The development of a standard set of surgical guides may eliminate the issues with the manufacturing process. To evaluate the feasibility of this option, a statistical shape model (SSM) was created and used to analyse the morphological variations of the T4–T6 vertebrae in a population of 90 specimens from the Visible Korean Human dataset (50 females and 40 males). The first three principal components, representing 39.7% of the variance within the population, were analysed. The model showed high variability in the transverse process (~ 4 mm) and spinous process (~ 4 mm) and relatively low variation (< 1 mm) in the vertebral lamina. For a Korean population, a standardised set of surgical guides would likely need to align with the lamina where the variance in the population is lower. It is recommended that this standard set of surgical guides should accommodate pedicle screw diameters of 3.5–6 mm and transverse pedicle screw angles of 3.5°–12.4°.
Issue Date: 1-Feb-2023
Date of Acceptance: 6-Sep-2022
URI: http://hdl.handle.net/10044/1/100249
DOI: 10.1007/s10237-022-01636-8
ISSN: 1617-7940
Publisher: Springer
Start Page: 123
End Page: 132
Journal / Book Title: Biomechanics and Modeling in Mechanobiology
Volume: 22
Copyright Statement: © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publication Status: Published
Online Publication Date: 2022-09-19
Appears in Collections:Mechanical Engineering
Faculty of Engineering

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