3D Digital Anatomical Models Based on Computed Tomographic Morphometric Analysis of C1 and C2 for Surgical Navigation.

Abstract

Background/Objectives: Injuries involving the Atlas (C1) and Axis (C2) vertebrae of the cervical spine present significant clinical challenges due to their complex anatomy and potential for severe neurological impairment. Traditional imaging methods often lack the detailed visualization required for precise surgical planning. This study aimed to develop high-resolution 3D models of the C1 and C2 vertebrae to perform a comprehensive morphometric analysis, identify gender differences, and assess bilateral symmetry to enhance surgical accuracy. Methods: A retrospective analysis was conducted using CT scans from 500 patients aged 18 and older from a single-center hospital. Three-dimensional models were generated using InVesalius 3.1 and visualized with Meshmixer. Morphometric measurements included screw placement angles, lamina length and height, bicortical diameters, and pedicle widths. Statistical analyses were conducted using SPSS, with the Student's t-test applied for gender and bilateral comparisons. Results: Significant gender differences were found in certain measurements, such as pedicle width (4.85 ± 0.90 mm in males vs. 4.60 ± 0.85 mm in females, p = 0.048) and C2 lamina height (12.90 ± 1.40 mm in males vs. 12.40 ± 1.25 mm in females, p = 0.033). Most measurements exhibited bilateral symmetry, supporting their applicability across genders. These results align with previous studies and highlight the importance of tailored surgical approaches. Conclusions: Three-dimensional models of the C1 and C2 provide comprehensive morphometric data that enhance preoperative planning and surgical precision. Integrating these models into clinical practice can reduce intraoperative risks and improve patient outcomes in cervical spine surgeries.