Ex vivo virtual and 3D printing methods for evaluating an anatomy‐based spinal instrumentation technique for the 12th thoracic vertebra

Abstract

Introduction Three‐dimensional printing and virtual simulation both provide useful methods of patient‐specific anatomical modeling for assessing and validating surgical techniques. A combination of these two methods for evaluating the feasibility of spinal instrumentation techniques based on anatomical landmarks has not previously been investigated. Materials and Methods Nineteen anonymized CT scans of the thoracic spine in adult patients were acquired. Maximum pedicle width and height were recorded, and statistical analysis demonstrated normal distributions. The images were converted into standard tessellation language (STL) files, and the T12 vertebrae were anatomically segmented. The intersection of two diagonal lines drawn from the lateral and medial borders of the T12 transverse process (TP) to the lateral border of the pars and inferolateral portion of the TP was identified on both sides of each segmented vertebra. A virtual screw was created and insertion into the pedicle on each side was simulated using the proposed landmarks. The vertebral STL files were then 3D‐printed, and 38 pedicles were instrumented according to the individual posterior landmarks used in the virtual investigation. Results There were no pedicle breaches using the proposed anatomical landmarks for insertion of T12 pedicle screws in the virtual simulation component. The technique was further validated by additive manufacturing of individual T12 vertebrae and demonstrated no breaches or model failures during live instrumentation using the proposed landmarks. Conclusions Ex vivo modeling through virtual simulation and 3D printing provides a powerful and cost‐effective means of replicating vital anatomical structures for investigation of complex surgical techniques.

Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

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The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals—Cross-Sectional Multispecialty Review

“…This is an alternative to classical methods based on intraoperative navigation and robotic systems, which are not always available [ 106 ]. Similar ex vivo virtual planning of spinal instrumentation was studied for the thoracic spine [ 107 ].…”