Angle control pedicle screw implantation tool in conjunction with a 3D model and guide plate to assist in accuracy of screw implantation

Yang Zhenyuan; Zhang Jiwei; Zhang Kaidong; Ma Bingqing; Zhang Yanjun; Li Junjie

doi:10.12307/2026.059

Abstract：BACKGROUND:Pedicle screws are widely used in spine surgery,and their precise placement is the focus of attention.In this study,a new pedicle screw placement method was explored to improve the accuracy of clinical nail placement. OBJECTIVE:To observe the application value of the self-developed angle control pedicle screw implantation tool combined with 3D model and guide plate in auxiliary pedicle screw implantation. METHODS:Totally 96 patients with spinal surgery who received pedicle screw internal fixation from March 2023 to June 2024 were selected and divided into two groups by random sampling method,namely the assisted group and the freehand group,with 48 patients in each group.The assisted group used an angle-controlled pedicle screw implantation tool with 3D model and guide plate to assist screw implantation,while the freehand group relied on C-arm X-ray machine for positioning and freehand screw implantation.All patients underwent CT examination to evaluate the differences in the time,accuracy,and frequency of C-arm X-ray machine use between the two methods. RESULTS AND CONCLUSION:(1)A total of 286 screws were implanted in the assisted group,with an implantation time of(2.51±1.26)min/screw and an accurate implantation success rate of 95.8%,while(1.45±2.12)times/screw were required by using C-arm fluoroscopy equipment;264 screws were implanted in the freehand group,with an implantation time of(3.27±1.54)min/screw,an accurate implantation success rate of 87.2%,and the number of C-arm fluoroscopy was(2.19±1.73)times/screw.(2)In comparison,the assisted group showed significant advantages in these three indicators:shorter single screw implantation time,higher screw placement accuracy,and lower C-arm fluoroscopy times,which were significantly different from those in the freehand group(P<0.05).(3)It is concluded that the use of angle-controlled pedicle screw implantation tools,combined with 3D model and guide plate assist,in pedicle screw implantation surgery can significantly enhance accuracy,shorten the time needed for placement,as well as reduce radiation exposure,all of which have clinical applications.