Patient-specific desktop 3D-printed guides for pelvic tumour resection surgery: a precision study on cadavers

García-Sevilla, Mónica; Mediavilla-Santos, Lydia; Ruiz-Alba, María Teresa; Pérez-Mañanes, Rubén; Calvo-Haro, José Antonio; Pascau, Javier

doi:10.1007/s11548-021-02322-3

Cited by 12 publications

(24 citation statements)

References 16 publications

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“…However, these solutions usually require the implantation of titanium pins prior to the preoperative CT and are more invasive. Nevertheless, if registration relies on artificial landmarks located in the PSIs, the navigation accuracy is highly dependent on their correct placement, which is challenging to ensure [27]. If registration is computed from a single PSI, low registration errors can be misleading.…”

Section: Discussionmentioning

confidence: 99%

“…C and S PSIs also contained the socket to attach the navigation reference frame. A detailed description of the PSIs design can be found in [27]. The reference frame and PSIs were 3D-printed in Dental SG resin on a Formlabs Form2 3D printer.…”

Section: B Cadaveric Experimentsmentioning

confidence: 99%

“…Preoperative and postoperative data of the same case were aligned using a model to model registration (based on iterative closest points algorithm [31]) between the bone models. We extracted the transformation between preoperative and postoperative PSIs as explained in [27]. These transformations allowed us to characterize the displacement with respect to the planning position.…”

Section: Analysis Of Navigation Accuracymentioning

confidence: 99%

“…As mentioned earlier, we can identify two sources of error in each scenario: PSI placement and navigation. As placement errors have already been analyzed by García-Sevilla et al [27], here we focus on the errors introduced only by navigation and the ones resulting from the combination of both sources (total error). Total errors result from navigation errors (inaccuracies introduced by the tracking device or the user when recording the registration points) and incorrect placement of the PSIs, making the virtual plan differ from the real scene.…”

Section: Analysis Of Navigation Accuracymentioning

confidence: 99%

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Combining Surgical Navigation and 3D Printing for Less Invasive Pelvic Tumor Resections

et al. 2021

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Surgical interventions for musculoskeletal tumor resection are particularly challenging in the pelvic region due to their anatomical complexity and proximity to vital structures. Several techniques, such as surgical navigation or patient-specific instruments (PSIs), have been introduced to ensure accurate resection margins. However, their inclusion usually modifies the surgical approach making it more invasive. In this study, we propose to combine both techniques to reduce this invasiveness while improving the precision of the intervention. PSIs are used for image-to-patient registration and the installation of the navigation's reference frame. We tested and validated the proposed setup in a realistic surgical scenario with six cadavers (12 hemipelvis). The data collected during the experiment allowed us to study different resection scenarios, identifying the patient-specific instrument configurations that optimize navigation accuracy. The mean values obtained for maximum osteotomy deviation or MOD (maximum distance between the planned and actual osteotomy for each simulated scenario) were as follows: for ilium resections, 5.9 mm in the iliac crest and 1.65 mm in the supra-acetabular region, and for acetabulum resections, 3.44 mm, 1.88 mm, and 1.97 mm in the supra-acetabular, ischial and pubic regions, respectively. Additionally, those cases with image-to-patient registration error below 2 mm ensured MOD of 2 mm or lower. Our results show how combining several PSIs leads to low navigation errors and high precision while providing a less invasive surgical approach.

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Section: Discussionmentioning

confidence: 99%

Section: B Cadaveric Experimentsmentioning

confidence: 99%

Section: Analysis Of Navigation Accuracymentioning

confidence: 99%

Section: Analysis Of Navigation Accuracymentioning

confidence: 99%

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Combining Surgical Navigation and 3D Printing for Less Invasive Pelvic Tumor Resections

et al. 2021

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“…Furthermore, more accurate reduction and shorter operation times can be achieved [ 6 , 21 ]. Additionally multiple cadaveric studies on pelvic tumours demonstrated more accurate osteotomies with 3D-printed patient-specific instruments compared to the standard manual technique [ 8 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

3D printed composite model of pelvic osteochondroma and nerve roots

Fox

Kanawati

2021

3D Print Med

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Background 3D-printing has become increasingly utilized in the preoperative planning of clinical orthopaedics. Surgical treatment of bone tumours within the pelvis is challenging due to the complex 3D bone structure geometry, as well as the proximity of vital structures. We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Case presentation We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The bony pelvis and spine model was created using the CT, whereas the nerve roots were derived from the MRI and printed in an elastic material. 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Pelvic tumour surgery is inherently dangerous due to the delicate nature of the surrounding anatomy. The composite model enabled the surgeon to very carefully navigate the anatomy with a focused resection and extreme care knowing the exact proximity of the L3 and L4 nerve roots. Conclusion The patient had complete resection of this tumour, no neurological complication and full resolution of his symptoms due to careful, preoperative planning with the use of the composite 3D model.

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Guías impresas en 3D: ¿mejoran el control local y la supervivencia global en el tratamiento de los sarcomas pélvicos? Estudio de validación clínica

Fernández-Fernández,

Mediavilla-Santos,

Cuervo-Dehesa

et al. 2024

Revista Española de Cirugía Ortopédica y Traumatología

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Patient-specific desktop 3D-printed guides for pelvic tumour resection surgery: a precision study on cadavers

Cited by 12 publications

References 16 publications

Combining Surgical Navigation and 3D Printing for Less Invasive Pelvic Tumor Resections

Combining Surgical Navigation and 3D Printing for Less Invasive Pelvic Tumor Resections

3D printed composite model of pelvic osteochondroma and nerve roots

Guías impresas en 3D: ¿mejoran el control local y la supervivencia global en el tratamiento de los sarcomas pélvicos? Estudio de validación clínica

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