Comparison of insertion of implants freehand and guided by a patient-specific surgical drilling guide in the cervical spine of cats using three-dimensional rapid prototyping

Abstract

Owing to the anatomical complexity of the cervical spine and the numerous conditions that affect the region, surgical procedures that use the "Freehand" approach to insert metallic implants for spinal stabilization can lead to complications owing to its mispositioning, thus increasing the chances of being caused iatrogenic lesions in patients. The development of complementary imaging exams represents a great advance in veterinary medicine, assisting the surgeon in planning and performing complex procedures. Given the presentment, the present study aims to study the insertion of freehand implants, compared to those implanted by patient-specific surgical drilling guide manufactured by rapid three-dimensional prototyping in the cervical spine of ten cat cadavers. The animals will be divided equally by lot into two groups (GML= freehand group and GGC= surgical guide group). Will be allocated in the vertebral bodies of C5 and C6, in the ventrodorsal direction, flat titanium pins, 2 mm in diameter, partial perforating, on both sides (right and left) of each vertebra. The GML will use the right side of five specimens and the left side of the other five, and similarly the GGC will have five specimens allocated on the right side and five on the left. Previously the ten corpses will undergo computed tomography where the generated images will be sent to RadiAnt®, Blender® and Slicer 3D® software for later making punch guides using Repetier Host® software for 3D printing. After the implants are applied, the corpses will be referred for a new computed tomography, so that the accuracy of the insertion techniques can be evaluated by by statistical analysis with paired test, variance analysis and Tukey method using GraphPad software prism®.