Background The integration of computer‐aided design/computer‐aided manufacturing (CAD/CAM) tools and medicine is rapidly developing for designing medical devices. A novel design for a 3D‐printed patient‐specific surgical template for thoracic pedicle screw insertion, using a procedure based on reverse engineering, is presented. Methods The surgeon chooses the entry point on the vertebra. The optimal insertion direction and the size of the screws are defined via an algorithm on the basis of a patient‐specific vertebra CAD model. The template features an innovative shape for a comfortable and univocal placement and a novel disengaging device. Results Three spinal fusions were performed to test the template. Excellent results were achieved in terms of the accuracy of the screw positioning, reduction in surgery duration, and number of X‐rays. Conclusions A novel design for a customized, 3D‐printed surgical template for thoracic spinal arthrodesis was presented, and improvements in terms of precision, duration, and safety were achieved without changing the standard procedure.

BACKGROUND: Nowadays, the ergonomic study of the driving position is a critical aspect of automotive design. Indeed, due to the rising needs on the market, one focus for car industries is to improve the perceived comfort related to the cars’ interior. Driving a car for a prolonged time could cause complaints in some body-regions, especially in the lumbar-sacral area. Thus, special lumbar-sacral supports for driver seat has been proposed for reducing this kind of complaints. OBJECTIVE: Development of two virtual and physical models of lumbar-sacral support for improving both the lumbar/sacral and overall perceived comfort while driving. METHODS: Two prototypes of lumbar/sacral support have been realized: the first one was integrated into the seat, and the second one was shaped as a removable pillow (removable support). Fifty participants were asked to rate the perceived comfort in lab tests performed on a seating-buck by comparing three configurations (5 min each): a standard seat, seat with the removable support, seat with integrated support. Subjective data (by questionnaires) and objective data (interface pressure between backrest and driver) have been acquired and statistically processed. In addition, real driving tests have been performed to test the actual performance of the removable support in term of perceived comfort comparing it with the standard seat. RESULTS: Statistical correlations between subjective and objective data showed interesting results in comfort improvement through the adopted solutions. Real driving tests showed an improvement in comfort perception with the lumbar-sacral support towards the standard seat. CONCLUSIONS: Thanks to the virtual prototyping and the application of previous knowledge, coming from literature and experience, a solution for improving the overall comfort and reduce the lumbar/sacral pain while driving has been developed, tested, and assessed.

Spine surgery is based, nowadays, on the use of cutting-edge instruments that optimize the intervention processes in the operating room, with advantages that affect the patient himself. Among these, rapid prototyping is configured as a first-rate tool, thanks to its ability to detail the diagnostic treatment according to the specific pathological case under examination. An example of this technology is represented by the generation of a drilling template, to assist the surgeon in identifying the optimal direction of insertion of the pedicle screws, capable of significantly reduce intervention times, in addition to the inevitable exposure of the patient to ionizing radiation, to which he is subjected during a normal arthrodesis intervention procedure. The design of a drilling guide requires, however, a particular attention in identifying the undercuts present on the vertebral surface, those areas of the spinous process which, reported inside the cavity of the template, involve complications at the time of extraction. In parallel, it is vitally important to carry out an evaluation of its stability during its use. In this article, starting from the analysis of the interferences present during the insertion of the template, a semi-automatic correction model is proposed for the generation of a new profile of the same, which facilitates its extraction without causing injury to the vertebral regions involved from the contact with the mask.