Preliminary application of a multi-level 3D printing drill guide template for pedicle screw placement in severe and rigid scoliosis

Liu, Kun; Zhang, Qiang; Li, Xin; Zhao, Changsong; Quan, Xuemin; Zhao, Rugang; Chen, Zongfeng; Li, Yansheng

doi:10.1007/s00586-016-4926-1

Cited by 80 publications

(68 citation statements)

References 27 publications

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“…Combining 3D reconstruction and MR technology is a new mode of production, which is applied in many fields because of the advantages of visualization, plasticity, and rapid printing [40][41][42]. Moreover, it can also help surgeons to achieve accurate navigation and position in spinal surgery [43,44].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Wei

Yao

et al. 2019

J Orthop Surg Res

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Background The purpose of this study was to assess the clinical outcome of percutaneous kyphoplasty (PKP) assisted with mixed reality (MR) technology in treatment of osteoporotic vertebral compression fracture (OVCF) with intravertebral vacuum cleft (IVC). Method Forty cases of OVCF with IVC undergoing PKP were randomized into a MR technology-assisted group (group A) and a traditional C-arm fluoroscopy group (group B). Both groups were performed PKP and evaluated by VAS scores, ODI scores, radiological evidence of vertebral body height, and kyphotic angle (KA) at pre-operation and post-operation. The volume of injected cement, fluoroscopy times, and operation time were recorded. And cases of non-PMMA-endplates-contact(NPEC) in radiological evidence was also recorded postoperatively. The clinical outcomes and complications were evaluated afterwards. All patients received 10 to 14 months follow-up, with an average of 12 months. Result This MR-assisted group (group A) acquired more about the amount of the polymethyl methacrylate (PMMA) injection and postoperative vertebral height and less about postoperative KA, fluoroscopy times, and operation time compared with the control group (group B) ( P < 0.05). The VAS scores and ODI scores in both groups have improved, but more significantly in group A ( P < 0.05). Also, more cases achieve both-endplates-touching of cement in group A ( P < 0.05). And there are less of the loss of vertebral height, KA, and occurrence of re-collapse of the vertebra in group A during the follow-up ( P < 0.05). Conclusion PKP assisted with MR technology can accurately orientate the position of IVC area, which can be augmented by the balloon leading to more satisfied vertebral height improvement, cement diffusion, and pain relief. Trial registration ClinicalTrials.gov Identifier: NCT03959059 . Registered 25 September 2016.

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Section: Discussionmentioning

confidence: 99%

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Wei

Yao

et al. 2019

J Orthop Surg Res

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“…In order to reduce the misplacement of pedicle screws in AIS, extra-pedicle screws [20], PPSs, cannulate pedicle screws [8], intraoperative navigation, robot-assisted pedicle screws [21] and 3D-printing drill guide template [22] have been developed. Recently, some studies have reported the clinical use of cannulated pedicle screws.…”

Section: Discussionmentioning

confidence: 99%

Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

Zhao

Liu

Yuan

et al. 2020

Preprint

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Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

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“…Computer assisted surgery can be used to monitor the placement of screws and increase the safety of these procedures. However this system is very expensive, complex to operate, cumbersome, has a long learning curve, often requires additional personnel and is associated with prolonged intra-operative time due to bone registration requirements (32,35,39). There are also issues with intra-operative changes in position, decreasing the accuracy of this technique (32).…”

Section: Surgical Guidesmentioning

confidence: 99%

“…The use of intra-operative imaging increases harmful radiation exposure for both doctors and patients (30,(34)(35)(36). 3DP guides may offer an alternative as a simple, convenient, low cost and complexequipment free way to improve the accuracy of pedicle screw placement (30)(31)(32)(33)(34)(35)(36)(37)(39)(40)(41)(42)(43).…”

Section: Surgical Guidesmentioning

confidence: 99%

“…Next, a 3D model is generated by specialist software from which the optimal screw trajectory and size can be determined, often in consultation with the surgeon. Finally, a navigational template is designed and built with optimal screw trajectory, the surface of which is the inverse of the posterior vertebral surface to ensure a good fit and accuracy of screw insertion (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)55). Numerous studies demonstrated that the guides help to lower operation time, with Deng et al (37) suggesting this may decrease complications related to operative time (e.g., infection) (30,35,37,43).…”

Section: Surgical Guidesmentioning

confidence: 99%

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Systematic review of 3D printing in spinal surgery: the current state of play

et al. 2017

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Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.

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Preliminary application of a multi-level 3D printing drill guide template for pedicle screw placement in severe and rigid scoliosis

Abstract: With the application of multi-level template, the incidence of cortex perforation in severe and rigid scoliosis decreased and this technology is, therefore, potentially applicable in clinical practice.

Cited by 80 publications

References 27 publications

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

Systematic review of 3D printing in spinal surgery: the current state of play

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