The Value of Three-Dimensional Printing Spine Model in Severe Spine Deformity Correction Surgery

Abstract

Study Design: Retrospective case-control study. Objective: We aimed to evaluate the value of 3-dimensional printing (3DP) spine model in the surgical treatment of severe spinal deformity since the prosperous development of 3DP technology. Methods: Severe scoliosis or hyper-kyphosis patients underwent posterior fixation and fusion surgery using the 3DP spine models were reviewed (3DP group). Spinal deformity surgeries operated by free-hand screw implantation during the same period were selected as the control group after propensity score matching (PSM). The correction rate, pedicle screw accuracy, and complications were analyzed. Class A and B screws were defined as accurate according to Gertzbein and Robbins criteria. Results: 35 patients were enrolled in the 3DP group and 35 matched cases were included in the control group. The perioperative baseline data and deformity correction rate were similar between both groups ( P > .05). However, the operation time and blood loss were significantly less in the 3DP group (296.14 ± 66.18 min vs. 329.43 ± 67.16 min, 711.43 ± 552.28 mL vs. 1322.29 ± 828.23 mL, P < .05). More three-column osteotomies (Grade 3-6) were performed in the 3DP group (30/35, 85.7% vs. 21/35, 60.0%. P = .016). The screw placement accuracy was significantly higher in the 3DP group (422/582, 72.51% vs. 397/575, 69.04%. P = .024). The screw misplacement related complication rate was significantly higher in the free-hand group (6/35 vs. 1/35, P = .046). Conclusions: The study provided solid evidence that 3DP spine models can enhance surgeons’ confidence in performing higher grade osteotomies and improve the safety and efficiency in severe spine deformity correction surgery. 3D printing technology has a good prospect in spinal deformity surgery.

The feasibility and efficacy of computer-assisted screw inserting planning in the surgical treatment for severe spinal deformity: a prospective study

“…Spinal deformity is a three-dimensional pathology, leading to coronal and sagittal plane decompensation, and can result in clinical complaints, neurological deficits, deformity progression, trunk imbalance and cardiopulmonary dysfunction [ 18 – 21 ]. Treatment of severe spinal deformity is one of the ultimate challenges for spine surgeons [ 22 ]. Literatures reported the incidence of neurological complications in spinal deformity correction surgeries was 1–27% [ 5 , 9 , 23 – 25 ], and with regard to new neurological deficits, the incidence was reported as 0.178–9.4%, and 33.6% of it was related to spinal instruments [ 9 , 23 ].…”

Proximal Thoracic Kyphoscoliosis with Dorsal Myelopathy in a Case of Congenital Absence of Thoracic Pedicles

“…The life size 3D model allows simulation surgery before the real one, increases surgeons' confidence, and improves the accuracy and consistency of pedicle screw placement 16 . The main indi-cations of using such models are severe scoliosis (>100°), revision cases with distorted reference points for pedicular entry, and multiplanar complex deformities 17 . We reproduced the osseous anatomy into a 3D printed model which enabled us to plan the surgery better.…”

Comparison of 3D-printed Navigation Template-assisted Pedicle Screws versus Freehand Screws for Scoliosis in Children and Adolescents: A Systematic Review and Meta-analysis

“…Our meta-analysis validated the satisfactory efficacy of the 3D-printed navigation template-assisted screw placement technique in corrective surgery for AIS and CS patients, which provides a breakthrough for improving the surgical precision of this special population. [6][7][8][9] Accepted Manuscript This article is protected by copyright. All rights reserved.…”

“…In recent years, the application of the 3D-printed navigation template technique has become more and more extensive. Some studies have compared the screw placement methods between 3Dprinted navigation templates and free-hand techniques in the surgical treatment of scoliosis, [6][7][8][9] they found that the accuracy of 3D-printed navigation template-assisted screw placement may be higher than that of the free-hand technique. However, most relevant literature about 3D-printed navigation templates contained a small sample, [10][11][12][13] so there was still no clear conclusion on its actual clinical effect in spinal corrective surgery.…”