Crossed Intralaminar Screws for Fusion of the Cervicothoracic Junction and the Thoracic Spine: The Experience in an Iberic Service with Case Series and Review of the Current Literature with Technique Description

The treatment of pathologies in the thoracic spine is a challenge. The periodic failure of pedicle screw insertion and anatomical variations make the search for an alternative to pedicle screws in thoracic spine surgery necessary. The interlaminar crossed screws is a well-known and secure method for fusion in cervical spine, and in thoracic spine there used to be insufficient clinical data to support this technique, until now. We demonstrate in an initial series of 10 cases treated with interlaminar fusion in association of other fusion techniques in the thoracic spine with good results. Objective: Intralaminar screws have been shown to be a biomechanical salvage technique in the thoracic spine, especially in long cervicothoracic, thoracic and thoracolumbar fixation. The goals of this article are to demonstrate our initial experience and the range of indications for thoracic crossed intralaminar screws. Methods: In this article we describe our initial series performed at S&#227o Teot&#243nio Hospital in Viseu, Portugal, and our results, and also provide a comprehensive review of the recent literature in the use of intralaminar crossed fixation.

Additive manufactured osseointegrated screws with hierarchical design

Bone screws are devices used to fix implants or bones to bones.However,conventional screws are mechanically fixed with thread and often face long-term failure due to poor osseointegration.To improve osseointegration,screws are evolving from solid and smooth to porous and rough.Additive manufacturing(AM)offers a high degree of manufacturing freedom,enabling the preparation of predesigned screws that are porous and rough.This paper provides an overview of the problems currently faced by bone screws:long-term loosening and screw breakage.Next,advances in osseointegrated screws are summarized hierarchically(sub-micro,micro,and macro).At the sub-microscale level,we describe surface-modification techniques for enhancing osseointegration.At the micro level,we summarize the micro-design parameters that affect the mechanical and biological properties of porous osseointegrated screws,including porosity,pore size,and pore shape.In addition,we highlight three promising pore shapes:triply periodic minimal surface,auxetic structure with negative Poisson ratio,and the Voronoi structure.At the macro level,we outline the strategies of graded design,gradient design,and topology optimization design to improve the mechanical strength of porous osseointegrated screws.Simultaneously,this paper outlines advances in AM technology for enhancing the mechanical properties of porous osseointegrated screws.AM osseointegrated screws with hierarchical design are expected to provide excellent long-term fixation and the required mechanical strength.

Biomechanical effects of posterior lumbar interbody fusion with vertical placement of pedicle screws compared to traditional placement

BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.

Comparative efficacy of proximal femoral nail vs dynamic condylar screw in treating unstable intertrochanteric fractures

BACKGROUND Among the most frequent hip fractures are trochanteric fractures,which usually occur from low-energy trauma like minor falls,especially in older people with osteoporotic bones.AIM To evaluate the treatment efficacy of dynamic condylar screws(DCS)and proximal femoral nails(PFN)for unstable intertrochanteric fractures.METHODS To find pertinent randomized controlled trials and retrospective observational studies comparing PFN with DCS for the management of unstable femoral intertrochanteric fractures,a thorough search was carried out.For research studies published between January 1996 and April 2024,PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar were all searched.The complete texts of the papers were retrieved,vetted,and independently examined by two investigators.Disputes were settled by consensus,and any disagreements that persisted were arbitrated by a third author.RESULTS This study included six articles,comprising a total of 173 patients.Compared to the DCS,the PFN had a shorter operation time[mean difference(MD):-41.7 min,95%confidence interval(95%CI):-63.04 to-20.35,P=0.0001],higher success rates with closed reduction techniques[risk ratio(RR):34.05,95%CI:11.12-104.31,P<0.00001],and required less intraoperative blood transfusion(MD:-1.4 units,95%CI:-1.80 to-1.00,P<0.00001).Additionally,the PFN showed shorter fracture union time(MD:-6.92 wk,95%CI:-10.27 to-3.57,P<0.0001)and a lower incidence of reoperation(RR:0.37,95%CI:0.17-0.82,P=0.01).However,there was no discernible variation regarding hospital stay,implant-related complications,and infections.CONCLUSION Compared to DCS,PFN offers shorter operative times,reduces the blood transfusions requirements,achieves higher closed reduction success,enables faster fracture healing,and lowers reoperation incidence.

Roller Screw and Threaded Chain Speed Reducer: An Experimental Evaluation

We are developing a speed reducer that can be considered a transformation of a worm gear reducer: the worm is replaced by an inverted roller screw, and the gear is replaced by a threaded chain drive. This configuration lessens wear, increases load capacity, and improves efficiency. The threaded chain consists of nut-shaped links. This paper presents the results of tests carried out on a prototype with a reduction ratio of 46.

Clinical Effectiveness of the Plate Screw Internal Fixation Technique in the Treatment of Patients with Traumatic Fractures of Long Bones in the Lower Extremities

Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.

Numerical Simulations of Polymer Melt Conveying in Co-Rotating Twin Screw Extruder

The 3 D non isothermal flow of non Newtonian viscous polymer melt in a co rotating twin screw extruder is modeled. The distributions of the velocity, temperature, pressure and the viscous dissipation in the flow domain are presented by using a fluid dynamics analysis package (Polyflow). The numerical results show that the temperatures are high in the intermeshing region and on the screw surface, the maximum pressure and the minimum pressure occur in the intermeshing region, and the flow rate is almost proportional to the screw speed.

Kinematics and Dynamics Hessian Matrices of Manipulators Based on Screw Theory

The complexity of the kinematics and dynamics of a manipulator makes it necessary to simplify the modeling process.However,the traditional representations cannot achieve this because of the absence of coordinate invariance.Therefore,the coordinate invariant method is an important research issue.First,the rigid-body acceleration,the time derivative of the twist,is proved to be a screw,and its physical meaning is explained.Based on the twist and the rigid-body acceleration,the acceleration of the end-effector is expressed as a linear-bilinear form,and the kinematics Hessian matrix of the manipulator（represented by Lie bracket）is deduced.Further,Newton-Euler＇s equation is rewritten as a linear-bilinear form,from which the dynamics Hessian matrix of a rigid body is obtained.The formulae and the dynamics Hessian matrix are proved to be coordinate invariant.Referring to the principle of virtual work,the dynamics Hessian matrix of the parallel manipulator is gotten and the detailed dynamic model is derived.An index of dynamical coupling based on dynamics Hessian matrix is presented.In the end,a foldable parallel manipulator is taken as an example to validate the deduced kinematics and dynamics formulae.The screw theory based method can simplify the kinematics and dynamics of a manipulator,also the corresponding dynamics Hessian matrix can be used to evaluate the dynamical coupling of a manipulator.

A Finite and Instantaneous Screw Based Approach for Topology Design and Kinematic Analysis of 5-Axis Parallel Kinematic Machines

Unifying the models for topology design and kinematic analysis has long been a desire for the research of parallel kinematic machines(PKMs). This requires that analytical description, formulation and operation for both finite and instantaneous motions are performed by the same mathematical tool. Based upon finite and instantaneous screw theory, a unified and systematic approach for topology design and kinematic analysis of PKMs is proposed in this paper. Using the derivative mapping between finite and instantaneous screws built in the authors’ previous work, the finite and instantaneous motions of PKMs are analytically described by the simple and non?redundant screws in quasi?vector and vector forms. And topological and parametric models of PKMs are algebraically formulated and related. These related topological and parametric models are ready to do type synthesis and kinematic analysis of PKMs under the unified framework of screw theory. In order to show the validity of the proposed approach, a kind of two?translational and three?rotational(2T3R)5?axis PKMs is taken as example. Numerous new structures of the 2T3R PKMs are synthe?sized as the results of topology design, and their Jacobian matrix is obtained easily for parameter optimization and performance evaluation. Some of the synthesized PKMs have outstanding capabilities in terms of large workspaces and flexible orientations, and have great potential for industrial applications of machining and manufacture. Among them, METROM PKM is a typical example which has attracted a lot of attention from global companies and already been developed as commercial products. The approach is a general and unified approach that can be used in the innovative design of different kinds of PKMs.

Kinematics and Dynamics of Deployable Structures with Scissor-Like-Elements Based on Screw Theory

Because the deployable structures are complex multi-loop structures and methods of derivation which lead to simpler kinematic and dynamic equations of motion are the subject of research effort, the kinematics and dynamics of deployable structures with scissor-like-elements are presented based on screw theory and the principle of virtual work respectively. According to the geometric characteristic of the deployable structure examined, the basic structural unit is the common scissor-like-element（SLE）. First, a spatial deployable structure, comprised of three SLEs, is defined, and the constraint topology graph is obtained. The equations of motion are then derived based on screw theory and the geometric nature of scissor elements. Second, to develop the dynamics of the whole deployable structure, the local coordinates of the SLEs and the Jacobian matrices of the center of mass of the deployable structure are derived. Then, the equivalent forces are assembled and added in the equations of motion based on the principle of virtual work. Finally, dynamic behavior and unfolded process of the deployable structure are simulated. Its figures of velocity, acceleration and input torque are obtained based on the simulate results. Screw theory not only provides an efficient solution formulation and theory guidance for complex multi-closed loop deployable structures, but also extends the method to solve dynamics of deployable structures. As an efficient mathematical tool, the simper equations of motion are derived based on screw theory.

Position and complications of pedicle screw insertion with or without image-navigation techniques in the thoracolumbar spine:a meta-analysis of comparative studies

Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications.However,some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques.Additionally,inconsistent conclusions have been drawn in various studies due to different population characteristics and methods used to assess the accuracy of screw placement.Moreover,it is not clear whether pedicle screw insertion with navigation techniques decreases the incidence of screw-related complications.Therefore,this study was sought to perform a meta-analysis of all available prospective evidence regarding pedicle screw insertion with or without navigation techniques in human thoracic and lumbar spine.We considered in vivo comparative studies that assessed the results of pedicle screw placement with or without navigation techniques.PubMed,Ovid MEDLINE and EMBASE databases were searched.Three published randomized controlled trials（RCTs） and nine retrospective comparative studies met the inclusion criteria.These studies included a total of 732 patients in whom 4,953 screws were inserted.In conclusion,accuracy of the position of grade I,II,III and IV screws and complication rate related to pedicle screw placement were significantly increased when navigation techniques were used in comparison to conventional techniques.Future research in this area should include RCTs with well-planned methodology to limit bias and report on validated,patient-based outcome measures.

Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures

Pelvic fractures are often caused by high-energy injuries and accompanied by hemodynamic instability.Traditional open surgery has a large amount of bleeding,which is not suitable for patients with acute pelvic fracture.Navigationguided,percutaneous puncture-screw implantation has gradually become a preferred procedure due to its advantages,which include less trauma,faster recovery times,and less bleeding.However,due to the complexity of pelvic anatomy,doctors often encounter some problems when using navigation to treat pelvic fractures.This article reviews the indications,contraindications,surgical procedures,and related complications of this procedure for the treatment of sacral fractures,sacroiliac joint injuries,pelvic ring injuries,and acetabular fractures.We also analyze the causes of inaccurate screw placement.Percutaneous screw placement under navigational guidance has the advantages of high accuracy,low incidence of complications and small soft-tissue damage,minimal blood loss,short hospital stays,and quick recovery.There is no difference in the incidence of complications between surgeries performed by new doctors and experienced ones.However,computer navigation technology requires extensive training,and attention should be given to avoid complications such as screw misplacement,intestinal injury,and serious blood vessel and nerve injuries caused by navigational drift.

Mobility Analysis of the Deployable Structure of SLE Based on Screw Theory

Scissor-like element has a number of applications in deployable structures such as planar deployable structure (PDS) and ring deployable structure(RDS). However, the mobility analysis of the multi-loop deployable structures is made more difficulty by the traditional mobility formula, because the deployable structure is a very complex structure with multi-loop. Therefore, On the basis of screw theory, the calculation method of mobility of deployable structures of SLE is thoroughly discussed. In order to investigate the mobility, decomposing and composing structures(DCS) are developed, and the basic units are able to be obtained. On the basis of the deployable structures’ geometrical characteristics, there exists a closed-loop quadrilateral structure and some non-closed-loop quadrilateral structures in PDS. Also, a six legs parallel structure is present in RDS. The basic units’ mobility can be solved by both the methods of screw theory and topology constraint graphs. Then, composing the related basic units, the formula of planar deployable structures’ mobility can be built and solves the mobility of ring deployable structure. The analysis method solves the mobility analysis of the multi-loop deployable structures which is difficulty by the traditional method, and plays an important role in further research about the mobility of other complex deployable structures.

Limit analysis of vertical anti-pulling screw pile group under inclined loading on 3D elastic-plastic finite element strength reduction method

Based on the functional theory, catastrophe theory, simultaneity principle and the idea of strength reduction method （SRM）, the bearing capacity functional anti SRM of pile group foundation were established, and the criteria of ultimate load and the concept of safety storage coefficient （Css） were advanced. The inclined ultimate loads by the static loading test, load increment method （LIM） and SRM are compared. Theoretically, the ultimate load of piles does not change with the loading levels when it is calculated by SRM. When the one strength reduction parameter is applied in the calculation boundary, there are calculating errors because the bearing capacity action of soils happened in the finite zone. The inclined 10adings are 108, 132 and 144 kN, and SSC are 1.07, 0.94 and 0.79, respectively, so the calculation values of ultimate loads are about 115.56, 124.08 and 113.76 kN, respectively. The error between calculations and observation values is less than 6%. But .the error between calculations of LIM and observations is 20%. Because of the effect of inclined loading, the push-rotation phenomenon of screw pile group appears. Under this testing, the ultimate bearing capacity of piles is mostly determined by the horizontal ultimate bearing capacity, and the effect of the vertical component of inclined load should also be considered.

Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.

Posterior Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis Patients:a Comparison of All Pedicle Screws versus Hybrid Instrumentation

Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4% （1/25） and 7.1% （1/14） respectively, with no significant difference （P〉0.05）.

Reciprocal Screw Theory Based Singularity Analysis of a Novel 3-DOF Parallel Manipulator

Singularity analysis is an essential issue for the development and application of parallel manipulators.Most of the existing researches focus on the singularity of parallel manipulators are carried out based on the study of Jacobian matrices.A 3-DOF parallel manipulator with symmetrical structure is presented.The novel parallel manipulator employs only revolute joints and consists of four closed-loop subchains connecting to both base and platform via revolute joints.The closed-loop subchain in each chain-leg is a spherical 6R linkage.The motion characteristics of the output link in the spherical 6R linkage with symmetrical structure are analyzed based on the interrelationships between screw systems.The constraints that are exerted on the platform by each chain-leg are investigated applying the concept of generalized kinematic pair in terms of equivalent screw system.Considering the geometric characteristics of the parallel manipulator,the singularity criteria of the parallel manipulator corresponding to different configurations are revealed based on the dependency of screw system and line geometry.The existing conditions of certain configuration that a singularity must occur are determined.This paper presents a new way of singularity analysis based on disposition of constraint forces on the geometrically identified constraint plane and the proposed approach is capable of avoiding the complexity in solving the Jacobian matrices.

Experimental Study and Preliminary Clinical Application of Miniinvasive Percutaneous Internal Screw Fixation for Scaphoid Fracture under the Guidance of a 3D-printed Guide Plate

This study explored the feasibility of employing computer-aided design(CAD)and 3 dimensional(3D)-printed personalized guide plate for the mini-invasive percutaneous internal screw fixation of fractured scaphoid.The study consisted of two parts:(1)experimentation on upper limbs from corpses and(2)preliminary clinical application.Corpse experiments involved upper limbs of 6 adult corpses.The specimens of upper limbs were subjected to plain CT scan.Then the CT data were input into computer to conduct 3D reconstruction of wrist region.The direction and depth of the guide wire and screw were designed on the basis of the principle that screw should lie at the center of scaphoid and the long axis of the screw should be aligned with that of the scaphoid.The carpal bone model and the guide plate were designed and 3D-printed.By using the guide plates,the guide wire was placed and the cannulated compression screw was inserted.The wrist region was examined by X-ray and CT to observe the location of the screw in the scaphoid.The scaphoid was longitudinally excised to grossly observe the location and evaluate the result of screw insertion.For clinical application,the guide plate was employed in 4 patients with fresh scaphoid fracture using the aforementioned operative technique.Our results showed that,in the 6 corpse limbs,the guide plate well fitted the skin surface and the guide wire and screw were accurately put in place in one session.X-ray examination and gross observation confirmed that the screw was satisfactorily positioned and the result met the requirements of the preoperative design.For 4 patients,the guide wire and screw were all precisely inserted into place in one session.The operation time and X-ray exposure times were apparently reduced.The imaging examination exhibited satisfactory results and the hand functioned well.It was concluded that the operative guide plate used for the mini­invasive percutaneous internal screw fixation of fractured scaphoid not only can assist in accurate placement of screw but also shorten operation time and reduce insertion and X-ray exposure times,thereby reducing the radiation injury and damage to the substance and the blood circulation of carpal bone.Its use can also improve the learning curve of surgeons.

Techniques and accuracy of thoracolumbar pedicle screw placement

Pedicle screw instrumentation has been used to stabilize the thoracolumbar spine for several decades. Although pedicle screws were originally placed via a freehand technique, there has been a movement in favor of pedicle screw placement with the aid of imaging. Such assistive techniques include fluoroscopy guidance and stereotactic navigation. Imaging has the benefit of increased visualization of a pedicle's trajectory, but can result in increased morbidity associated with radiation exposure, increased time expenditure, and possible workflow interruption. Many institutions have reported high accuracies with each of these three core techniques. However, due to differing definitions of accuracy and varying radiographic analyses, it is extremely difficult to compare studies side-by-side to determine which techniques are superior. From the literature, it can be concluded that pedicles of vertebrae within the mid-thoracic spine and vertebrae that have altered morphology due to scoliosis or other deformities are the most difficult to cannulate. Thus, spine surgeons would benefit the most from using assistive technologies in these circumstances. All other pedicles in thethoracolumbar spine should theoretically be cannulated with ease via a free-hand technique, given appropriate training and experience. Despite these global recommendations, appropriate techniques must be chosen at the surgeon's discretion. Such determinations should be based on the surgeon's experience and the specific pathology that will be treated.

Type Synthesis Method for the Translational Decoupled Parallel Mechanism Based on Screw Theory

Coupling is the significant characteristic of parallel mechanism,while it is just the coupling that brings about much difficulty for the configuration design,theoretical analysis and the development of the control system of the parallel mechanism. And recently,the research on the decoupled parallel mechanism becomes one of the research hot points in the mechanism fields. In this paper,a type synthesis method for the translational decoupled parallel mechanism( TDPM) is proposed based on the screw theory. To achieve the decoupling characteristics of the translational parallel mechanism,the translational decoupled criterion for type synthesis of the branches are presented in this paper. According to this criterion and the realization conditions of rotational degree of freedom of the mechanism proposed former,a large number of branches for the TDPM are obtained. Taking the three degrees of freedom( DOFs) TDPM as an example,the process of type synthesis is discussed in detail. Using this proposed type synthesis method,a serial of translational decoupled parallel mechanisms, including but not limited to all the existing typical 3-DOF TDPMs, are obtained, which identifies the correctness and effective of the method. The contents of this paper provide a reference and possess significant theoretical meanings for the synthesis and development of the novel decoupled parallel mechanisms.