C1–C2 FIKSATSIYASIDA INDIVIDUAL 3D OPERATSIYADAN OLDINGI REJALASHTIRISH: VINTLARNI JOYLASHTIRISH ANIQLIGI VA XAVFSIZLIGIGA TA’SIRI
##article.subject##:
atlantoaksial beqarorlik, 3D rejalashtirish, 3D chop etish, C1-C2 fiksatsiya, Goel-Harms, umurtqa arteriyasi##article.abstract##
Tadqiqotning maqsadi - atlantoaksial segmentning orqa fiksatsiyasida vintlarni o‘rnatish aniqligi va xavfsizligiga individual 3D preoperativ rejalashtirishning ta’sirini baholash. Goel-Harms usuli bilan operatsiya qilingan atlantoaksial beqarorlikka ega 10 nafar bemor ma’lumotlari tahlil qilindi. Operatsiyadan oldingi rejalashtirish MSKT ma’lumotlari asosida 3D Slicer dasturi yordamida va anatomik 3D modellarni chop etish orqali amalga oshirildi. Barcha holatlarda vintlar kortikal plastinkani shikastlamasdan aniq o‘rnatildi. O‘rtacha og‘ish 12,5° ± 3,7°, umurtqa arteriyasigacha minimal masofa 3,1 ± 0,8 mm ni tashkil etdi. Operatsiya davomiyligi 145 ± 18 daqiqa bo‘ldi. Klinik ko‘rsatkichlar (VAS, ASIA, NDI) sezilarli yaxshilandi. Asoratlar kuzatilmadi. Ushbu usul C1-C2 fiksatsiyasining aniqligi, xavfsizligi va samaradorligini oshiradi.
Библиографические ссылки
Buchmann N, Schweizer C, Kirschke JS, et al. C1-C2 posterior screw fixation in atlantoaxial fractures revisited: technical update based on 127 cases. Eur Spine J. 2020;29(5):1036–1042. doi:10.1007/s00586-019-06244-2.
Chin KR, Mills MV, Seale J, Cumming V. Ideal starting point and trajectory for C2 pedicle screw placement: a 3D computed tomography analysis using perioperative measurements. Spine J. 2014 Apr;14(4):615-8. doi: 10.1016/j.spinee.2013.06.077. Epub 2013 Nov 5. PMID: 24200408
Du YQ, Qiao GY, Yin YH, et al. Usefulness of 3D printed models in the management of complex craniovertebral junction anomalies: choice of treatment strategy, design of screw trajectory, and protection of vertebral artery. World Neurosurg. 2020;133:e722-e729. doi:10.1016/j.wneu.2019.09.139.
Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien). 1994;129(1–2):47–53. doi:10.1007/bf01400872.
Govsa F, Ozer MA, Biceroglu H, Karakas AB, Cagli S, Eraslan C, Alagoz AK. Creation of 3-Dimensional Life Size: Patient-Specific C1 Fracture Models for Screw Fixation. World Neurosurg. 2018 Jun;114:e173-e181. doi: 10.1016/j.wneu.2018.02.131. Epub 2018 Mar 3. PMID: 29510286.
Harms J, Melcher RP. Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine. 2001;26(22):2467–2471.
Kizmazoglu C, Ur K, Uzunoglu I, et al. Clinical and Radiological Outcomes of C1–C2 Fixation: 3D-Printed Template vs. Free-Hand Technique. J Clin Med. 2026;15(2):408. doi:10.3390/jcm15020408.
Li Y, Lin J, Wang Y, Luo H, Wang J, Lu S, Xu Y. Comparative study of 3D printed navigation template-assisted atlantoaxial pedicle screws versus free-hand screws for type II odontoid fractures. Eur Spine J. 2021 Feb;30(2):498-506. doi: 10.1007/s00586-020-06644-9. Epub 2020 Oct 23. PMID: 33098009.
Li Y, Wang H, Li X, Cui W, Zhou P, Xiao W, Wang Z. Comparison of accuracy in C1-C2 pedicle screw placement: O-arm, 3D guides, and C-arm fluoroscopy. Sci Rep. 2025 May 6;15(1):15731. doi: 10.1038/s41598-025-99884-y. PMID: 40325178; PMCID: PMC12053667.
Lvov I, Grin A, Talypov A, et al. Efficacy and Safety of Goel-Harms Technique in Upper Cervical Spine Surgery: A Systematic Review and Meta-Analysis. World Neurosurg. 2022;167:e1169-e1184. doi:10.1016/j.wneu.2022.09.016.
Rashim K, Verma PK, Sinha VD. Increasing the safety of surgical treatment for complex cranio-vertebral anomalies using customized 3D printed models. J Clin Neurosci. 2018;48:203–208. doi:10.1016/j.jocn.2017.10.061.
Zhang JX, Ke ZY, Zhao GS, et al. Application of 3D Slicer for preoperative planning in upper cervical posterior fixation with vertebral artery variations. Sci Rep. 2025;15(1):27492. doi:10.1038/s41598-025-13469-3.
