A 3D navigation template for guiding a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation: a study protocol for multicentre randomised controlled trials

BMJ Open. 2017 Jul 21;7(7):e016328. doi: 10.1136/bmjopen-2017-016328.

Abstract

Introduction: The incidence of lumbar disc degeneration disease has increased in recent years. Lumbar interbody fusion using two unilateral pedicle screws and a translaminar facet screw fixation has advantages of minimal invasiveness and lower costs compared with the traditional methods. Moreover, a method guided by a three-dimensional (3D) navigation template may help us improve the surgical accuracy and the success rate. This is the first randomised study using a 3D navigation template to guide a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation.

Methods and analysis: Patients who meet the criteria of the surgery will be randomly divided into experimental groups and control groups by a computer-generated randomisation schedule. We will preoperatively design an individual 3D navigation template using CATIA software and MeditoolCreate. The following primary outcomes will be collected: screw angles compared with the optimal screw trajectories in 3D digital images, length of the wound incision, operative time, intraoperative blood loss and complications. The following secondary outcomes will be collected: visual analogue scale (VAS) for back pain, VAS for leg pain and the Oswestry Disability Index. These parameters will be evaluated on day 1 and then 3, 6, 12 and 24 months postoperatively.

Ethics and dissemination: The study has been reviewed and approved by the institutional ethics review board of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University. The results will be presented at scientific communities and peer-reviewed journals.

Trial registration number: ChiCTR-IDR-17010466.

Keywords: 3D navigation template; multicentre randomized controlled trials; study protocol; translaminar facet screw fixation.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Bone Screws*
  • Costs and Cost Analysis
  • Hemorrhage
  • Humans
  • Imaging, Three-Dimensional*
  • Intervertebral Disc Degeneration / complications
  • Intervertebral Disc Degeneration / surgery*
  • Intraoperative Complications
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Lumbosacral Region / pathology
  • Lumbosacral Region / surgery*
  • Middle Aged
  • Operative Time
  • Pain / etiology
  • Pain Measurement
  • Pedicle Screws
  • Research Design
  • Spinal Fusion / methods*
  • Treatment Outcome
  • Young Adult