The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study
Abstract Background Restoration of cervical lordosis after anterior discectomy and fusion is a desirable goal. Proper insertion of the vertebral distraction or Caspar pin can assist lordotic restoration by either putting the tips divergently or parallel to the index vertebral endplates. With inexper...
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doaj-959ec611c3664b0c91049a22f0eb3cb82021-08-01T11:30:34ZengBMCBMC Musculoskeletal Disorders1471-24742021-07-012211810.1186/s12891-021-04533-wThe aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility studyTorphong Bunmaprasert0Sittichai Luangkittikong1Menghong Tosinthiti2Supachoke Nivescharoenpisan3Raphi Raphitphan4Nantawit Sugandhavesa5Wongthawat Liawrungrueang6K. Daniel Riew7Department of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Orthopaedics, Faculty of Medicine, Chiang Mai UniversityDepartment of Neurological Surgery, Weill Cornell MedicineAbstract Background Restoration of cervical lordosis after anterior discectomy and fusion is a desirable goal. Proper insertion of the vertebral distraction or Caspar pin can assist lordotic restoration by either putting the tips divergently or parallel to the index vertebral endplates. With inexperienced surgeons, the traditional free-hand technique for Caspar pin insertion may require multiple insertion attempts that may compromise the vertebral body and increase radiation exposure during pin localization. Our purpose is to perform a proof-of-concept, feasibility study to evaluate the effectiveness of a pin insertion aiming device for vertebral distraction pin insertion. Methods A Smith-Robinson approach and anterior cervical discectomy were performed from C3 to C7 in 10 human cadaveric specimens. Caspar pins were inserted using a novel pin insertion aiming device at C3-4, C4-5, C5-6, and C6-7. The angles between the cervical endplate slope and Caspar pin alignment were measured with lateral cervical imaging. Results The average Superior Endplate-to-Caspar Pin angle (SE-CP) and the average Inferior Endplate-to-Caspar Pin angle (IE-CP) were 6.2 ± 2.0° and 6.3 ± 2.2° respectively. For the proximal pins, the SE-CP and the IE-CP were 4.0 ± 1.1°and 5.2 ± 2.4° respectively. For the distal pins, the SE-CP and the IE-CP were 7.7 ± 1.4° and 6.2 ± 2.0° respectively. No cervical endplate violations occurred. Conclusion The novel Caspar pin insertion aiming device can control the pin entry points and pin direction with the average SE-CP and average IE-CP of 6.2 ± 2.0° and 6.3 ± 2.2°, respectively. The study shows that the average different angles between the Caspar pin and cervical endplate are less than 7°.https://doi.org/10.1186/s12891-021-04533-wCaspar vertebral distraction pin insertionAnterior cervical surgeryCervical spine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Torphong Bunmaprasert Sittichai Luangkittikong Menghong Tosinthiti Supachoke Nivescharoenpisan Raphi Raphitphan Nantawit Sugandhavesa Wongthawat Liawrungrueang K. Daniel Riew |
spellingShingle |
Torphong Bunmaprasert Sittichai Luangkittikong Menghong Tosinthiti Supachoke Nivescharoenpisan Raphi Raphitphan Nantawit Sugandhavesa Wongthawat Liawrungrueang K. Daniel Riew The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study BMC Musculoskeletal Disorders Caspar vertebral distraction pin insertion Anterior cervical surgery Cervical spine |
author_facet |
Torphong Bunmaprasert Sittichai Luangkittikong Menghong Tosinthiti Supachoke Nivescharoenpisan Raphi Raphitphan Nantawit Sugandhavesa Wongthawat Liawrungrueang K. Daniel Riew |
author_sort |
Torphong Bunmaprasert |
title |
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
title_short |
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
title_full |
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
title_fullStr |
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
title_full_unstemmed |
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
title_sort |
aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2021-07-01 |
description |
Abstract Background Restoration of cervical lordosis after anterior discectomy and fusion is a desirable goal. Proper insertion of the vertebral distraction or Caspar pin can assist lordotic restoration by either putting the tips divergently or parallel to the index vertebral endplates. With inexperienced surgeons, the traditional free-hand technique for Caspar pin insertion may require multiple insertion attempts that may compromise the vertebral body and increase radiation exposure during pin localization. Our purpose is to perform a proof-of-concept, feasibility study to evaluate the effectiveness of a pin insertion aiming device for vertebral distraction pin insertion. Methods A Smith-Robinson approach and anterior cervical discectomy were performed from C3 to C7 in 10 human cadaveric specimens. Caspar pins were inserted using a novel pin insertion aiming device at C3-4, C4-5, C5-6, and C6-7. The angles between the cervical endplate slope and Caspar pin alignment were measured with lateral cervical imaging. Results The average Superior Endplate-to-Caspar Pin angle (SE-CP) and the average Inferior Endplate-to-Caspar Pin angle (IE-CP) were 6.2 ± 2.0° and 6.3 ± 2.2° respectively. For the proximal pins, the SE-CP and the IE-CP were 4.0 ± 1.1°and 5.2 ± 2.4° respectively. For the distal pins, the SE-CP and the IE-CP were 7.7 ± 1.4° and 6.2 ± 2.0° respectively. No cervical endplate violations occurred. Conclusion The novel Caspar pin insertion aiming device can control the pin entry points and pin direction with the average SE-CP and average IE-CP of 6.2 ± 2.0° and 6.3 ± 2.2°, respectively. The study shows that the average different angles between the Caspar pin and cervical endplate are less than 7°. |
topic |
Caspar vertebral distraction pin insertion Anterior cervical surgery Cervical spine |
url |
https://doi.org/10.1186/s12891-021-04533-w |
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