{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T05:27:19Z","timestamp":1749274039659,"version":"3.30.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The aim of this study was to design a novel lumbar cortical bone trajectory (CBT) penetrating the anterior, middle, and posterior vertebral area using imaging; measure the relevant parameters to find theoretical parameters and screw placement possibilities; and investigate the optimal implantation trajectory of the CBT in patients with osteoporosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Three types of CBTs with appropriate lengths were selected to simulate screw placement using Mimics software. These CBTs were classified as the leading tip of the trajectory pointing to the posterior quarter area (original CBT [CBT-O]) and middle (novel CBT A [CBT-A]) and anterior quarter (novel CBT B [CBT-B]) of the superior endplate. The authors then measured the maximum screw diameter (MSD) and length (MSL), cephalad (CA) and lateral (LA) angles, and bone mineral density (Hounsfield unit [HU] values) of the planned novel 3-column CBT screw placements. The differences in the parameters of the novel CBTs, the percentages of successfully planned CBT screws, and the factors that influenced the successful planning of 3-column CBT screws were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Three-column CBT screws were successfully designed in all segments of the lumbar spine. The success rate of the 3-column CBT planned screws was 72.25% (83.25% for CBT-A and 61.25% for CBT-B). From the CBT-O type, to the CBT-A type, to the CBT-B type, the LA, CA, and MSD of the novel CBT screws decreased with increasing trajectory length. The HU values of the three types of trajectories were all significantly higher than that of the traditional pedicle screw trajectory (p &lt; 0.001). The main factor affecting successful planning of the 3-column CBT screw was pedicle width.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Moderating adjustment of the original screw parameters by reducing LAs and CAs to penetrate the anterior, middle, and posterior columns of the vertebral body using the 3-column CBT screw is feasible, especially in the lower lumbar spine.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.spine231208","type":"journal-article","created":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T01:44:04Z","timestamp":1716601444000},"page":"199-208","source":"Crossref","is-referenced-by-count":1,"title":["Design and radiological confirmation of 3-column cortical bone trajectory in the lumbar spine"],"prefix":"10.3171","volume":"41","author":[{"given":"Jia-Qi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren-Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu-Ping","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong-Yu","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Sheng","sequence":"additional","affiliation":[{"name":"Chaohu Clinical Medical College, Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Fang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Anhui Medical University, Hefei; and"},{"name":"3D-Printing and Tissue Engineering Center, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai-Liang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei;"},{"name":"Laboratory of Spinal and Spinal Cord Injury Regeneration and Repair, the First Affiliated Hospital of Anhui Medical University, Hefei;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Orthop Surg Res","first-page":"382","article-title":"Complication, fusion, and revision rate in the lumbar cortical bone trajectory and pedicle screw fixation techniques: a systematic review and meta-analysis","volume":"18","author":"Wang Y","year":"2023","unstructured":"Wang Y, Kahaer A, Maimaiti A, Guo H, Rexiti P. 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Heliyon. 2019;5(9):e02423."},{"issue":"6","key":"b26","series-title":"Spine (Phila Pa 1976)","first-page":"E335","article-title":"Fatigue performance of cortical bone trajectory screw compared with standard trajectory pedicle screw","volume":"41","author":"Akpolat YT","year":"2016","unstructured":"Akpolat YT, \u0130nceo\u011flu S, Kinne N, Hunt D, Cheng WK. Fatigue performance of cortical bone trajectory screw compared with standard trajectory pedicle screw. Spine (Phila Pa 1976). 2016;41(6):E335\u2013E341."},{"issue":"4","key":"b27","series-title":"Spine Surg Relat Res","first-page":"164","article-title":"Lumbar pedicle screw fixation with cortical bone trajectory: a review from anatomical and biomechanical standpoints","volume":"1","author":"Matsukawa K","year":"2017","unstructured":"Matsukawa K, Yato Y. Lumbar pedicle screw fixation with cortical bone trajectory: a review from anatomical and biomechanical standpoints. 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J Neurosurg Spine. 2014;21(2):203\u2013209."},{"issue":"3","key":"b31","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation","volume":"36","author":"Rodriguez A","year":"2014","unstructured":"Rodriguez A, Neal MT, Liu A, Somasundaram A, Hsu W, Branch CL Jr. Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation. Neurosurg Focus. 2014;36(3):E9."},{"issue":"5","key":"b32","series-title":"Eur Spine J","first-page":"1098","article-title":"Assessment of bone quality at the lumbar and sacral spine using CT scans: a retrospective feasibility study in 50 comparing CT and DXA data","volume":"29","author":"Berger-Groch J","year":"2020","unstructured":"Berger-Groch J, Thiesen DM, Ntalos D, Hennes F, Hartel MJ. Assessment of bone quality at the lumbar and sacral spine using CT scans: a retrospective feasibility study in 50 comparing CT and DXA data. Eur Spine J. 2020;29(5):1098\u20131104."},{"issue":"1","key":"b33","series-title":"J Orthop Surg Res","first-page":"128","article-title":"Differences in bone mineral density of trajectory between lumbar cortical and traditional pedicle screws","volume":"14","author":"Zhang R","year":"2019","unstructured":"Zhang R, Gao H, Li H,  Differences in bone mineral density of trajectory between lumbar cortical and traditional pedicle screws. J Orthop Surg Res. 2019;14(1):128."},{"issue":"7","key":"b34","series-title":"Am J Transl Res","first-page":"3906","article-title":"Associations between the Hounsfield unit values of different trajectories and bone mineral density of vertebrae: cortical bone and traditional trajectories","volume":"12","author":"Zhang RJ","year":"2020","unstructured":"Zhang RJ, Li HM, Gao H, Jia CY, Xing T, Shen CL. Associations between the Hounsfield unit values of different trajectories and bone mineral density of vertebrae: cortical bone and traditional trajectories. Am J Transl Res. 2020;12(7):3906\u20133916."},{"issue":"5","key":"b35","series-title":"Eur Spine J","first-page":"619","article-title":"Computer analysis of the safety of using three different pedicular screw insertion points in the lumbar spine in the Chinese population","volume":"16","author":"Hailong Y","year":"2007","unstructured":"Hailong Y, Wei L, Zhensheng M, Hongxun S. Computer analysis of the safety of using three different pedicular screw insertion points in the lumbar spine in the Chinese population. Eur Spine J. 2007;16(5):619\u2013623."},{"issue":"11","key":"b36","series-title":"J Am Acad Orthop Surg","first-page":"755","article-title":"Cortical bone trajectory technique for posterior spinal instrumentation","volume":"24","author":"Tortolani PJ","year":"2016","unstructured":"Tortolani PJ, Stroh DA. Cortical bone trajectory technique for posterior spinal instrumentation. J Am Acad Orthop Surg. 2016;24(11):755\u2013761."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/2\/article-p199.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/2\/article-p199.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/2\/article-p199.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:19:55Z","timestamp":1733491195000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/2\/article-p199.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":36,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2024.2.spine231208","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2024,8,1]]}}}