The Accuracy of 3D Printing Assistance in the Spinal Deformity Surgery

Chen, Po Chen; Chang, Chien Chun; Chen, Hsien Te; Lin, Chia Yu; Ho, Tsung Yu; Chen, Yen Jen; Tsai, Chun‐Hao; Tsou, Hsi‐Kai; Lin, Chih Sheng; Chen, Yi Wen; Hsu, Hsiang‐Chen

doi:10.1155/2019/7196528

Cited by 31 publications

(29 citation statements)

References 24 publications

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“…Planning for intraoperative use of navigation must take into account the imaging system and navigation platform available at the surgeon's facility. Use of active navigation without intraoperative CT imaging has been shown as a viable and cost-effective alternative to passive image-based 3D navigation platforms (8). Utilizing preoperative CT based drill guides, Sugawara et al reported 98.5% accuracy with screw placement in the cervicothoracic spine (9).…”

Section: Intraoperative Navigationmentioning

confidence: 99%

Preoperative planning for intraoperative navigation guidance

Sabri¹,

York²

2021

Ann Transl Med

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Intraoperative navigation for spinal procedures has continued to gain popularity. Numerous platforms are currently on the market and offer a spectrum of features. Preoperative considerations when utilizing this technology begin with understanding the fundamental concepts and methods of navigation.Several key factors including patient positioning, reference array placement, and sequence of instrumentation can help improve intraoperative navigation workflow when planned appropriately. The authors review current literature to help guide surgeon decision making when utilizing navigation. Additionally, tips and techniques for use of navigation are detailed to help avoid common surgeon pitfalls. In general, navigation platforms are classified based on image acquisition and degree of surgeon motion restriction during instrumentation. Imageless platforms often require preoperative images to be uploaded into the navigation system. Image-based systems rely on intraoperative imaging to ensure accuracy of its referencing software.The system then creates a three-dimensional model that allows for visualization of the navigated instrument within the surgical field. Active and passive navigation describe the degree of surgeon free-motion restriction when utilizing navigated instruments. Active navigation platforms, such as most robotic systems, prevent the deviation of the surgeon's instrument from a predetermined trajectory. Passive navigation does not restrict surgeon motion and the projected trajectory of the instrumented can be displayed on a three-dimensional model.

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Section: Intraoperative Navigationmentioning

confidence: 99%

Preoperative planning for intraoperative navigation guidance

Sabri¹,

York²

2021

Ann Transl Med

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“…С другой стороны, избыточная площадь контакта требует обширной диссекции мягких тканей и затрудняет визуализацию [18]. Включение в зону контакта граней остистого отростка при определенной его конфигурации может привести к невозможности совместить шаблон с задними структурами [13]. Многие авторы в качестве опорной точки с успехом использовали верхушку остистого отростка [12,13,15,[27][28][29].…”

Section: материал и методыunclassified

“…Включение в зону контакта граней остистого отростка при определенной его конфигурации может привести к невозможности совместить шаблон с задними структурами [13]. Многие авторы в качестве опорной точки с успехом использовали верхушку остистого отростка [12,13,15,[27][28][29]. Почти все исследователи применяли одноуровневые шаблоны [12, 13, 15-18, 22-24, 26, 27, 29], так как при этом минимизируется риск неточности позиционирования за счет смещения соседних позвонков.…”

Section: материал и методыunclassified

“…Конструкция направляющего элемента зависит от инструмента, который предпочитает использовать для формирования транспедикулярной трассы оператор. Большая часть авторов отдает предпочтение дрели, оснащенной сверлом [12,13,15,18,19,[23][24][25]28] или спицей Киршнера [17,27]. О применении шила сообщает меньшее число публикаций [10,14,16,26,29].…”

Section: материал и методыunclassified

“…Цель исследования -оценка корректности имплантации транспедикулярных винтов с использованием двухуровневых навигацион-ных шаблонов в позвонки грудного и поясничного отделов позвоночника при малых размерах корня дуги. ничном отделах позвоночника представлены менее широко [7][8][9], однако в ряде работ сообщается об успешном применении данного подхода в лечении подросткового идиопатического сколиоза [10][11][12][13][14][15][16][17], деформаций на фоне пороков развития [12-15, 18, 19], нейромышечных заболеваний [13,20], посттуберкулезного кифоза [12], анкилозирующего спондилита [21], окостенения задней продольной связки [22], а также при онкологических [22,23] и дегенеративных [24] поражениях и переломах позвонков [23,25].…”

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Transpedicular fixation of the spine with two-level navigation templates for narrow pedicles

et al. 2021

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Objective. To assess the correctness of transpedicular screw insertion in thoracic and lumbar vertebrae using two-level navigation templates for narrow pedicles.Material and Methods. Two-level navigation templates were used in surgical treatment of four patients aged 14–17 years with scoliotic deformity and multiple pedicles of small width (less than 4.35 mm). In each patient, the least favorable zones were selected for implantation using navigation templates. The rest of planned pedicle screws were inserted using free-hand technique. All patients underwent CT scanning postoperatively. Screws inserted to pedicles less than 4.35 mm in width were classified as correctly placed if they did not extend beyond the medial cortical layer by more than 2 mm.Results. Out of 68 pedicles planned for screw placement, 42 were narrower than 4.35 mm. In the pedicles difficult for implantation, 29 screws were inserted using navigation templates and 13 by free-hand technique. Screws classified as correctly placed were 28 from those inserted with navigation templates and 9 from those implanted by free-hand technique. Difference in results of screw placement in narrow pedicles with navigation templates and by free-hand technique was statistically significant (exact Fisher test, p < 0.05).Conclusion. Transpedicular screw placement with two-level navigation templates in narrow pedicles is more correct than insertion by free hand technique.

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3D Printing Technology in Pediatric Orthopedics: a Primer for the Clinician

Sabharwal

Bünker

et al. 2023

Curr Rev Musculoskelet Med

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Purpose of ReviewThis article reviews the basics of 3D printing and provides an overview of current and future applications of this emerging technology in pediatric orthopedic surgery. Recent Findings Both preoperative and intraoperative utilization of 3D printing technology have enhanced clinical care. Potential benefits include more accurate surgical planning, shortening of a surgical learning curve, decrease in intraoperative blood loss, less operative time, and fluoroscopic time. Furthermore, patient-specific instrumentation can be used to improve the safety and accuracy of surgical care. Patient-physician communication can also benefit from 3D printing technology. Summary 3D printing is rapidly advancing in the field of pediatric orthopedic surgery. It has the potential to increase the value of several pediatric orthopedic procedures by enhancing safety and accuracy while saving time. Future efforts in cost reduction strategies, making patient-specific implants including biologic substitutes and scaffolds, will further increase the relevance of 3D technology in the field of pediatric orthopedic surgery.

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The Accuracy of 3D Printing Assistance in the Spinal Deformity Surgery

Cited by 31 publications

References 24 publications

Preoperative planning for intraoperative navigation guidance

Preoperative planning for intraoperative navigation guidance

Transpedicular fixation of the spine with two-level navigation templates for narrow pedicles

3D Printing Technology in Pediatric Orthopedics: a Primer for the Clinician

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