Abstract:
STUDY DESIGN:Single-center retrospective case series. OBJECTIVE:The purpose of this study was to assess the safety and accuracy of three-dimensional (3D)-printed individualized drill guides for pedicle and lateral mass screw insertion in the cervical and upper-thoracic region, by comparing the preoperative 3D surgical plan with the postoperative results. SUMMARY OF BACKGROUND DATA:Posterior spinal fusion surgery can provide rigid intervertebral fixation but screw misplacement involves a high risk of neurovascular injury. However, modern spine surgeons now have tools such as virtual surgical planning and 3D-printed drill guides to facilitate spinal screw insertion. METHODS:A total of 15 patients who underwent posterior spinal fusion surgery involving patient-specific 3D-printed drill guides were included in this study. After segmentation of bone and screws, the postoperative models were superimposed onto the preoperative surgical plan. The accuracy of the realized screw trajectories was quantified by measuring the entry point and angular deviation. RESULTS:The 3D deviation analysis showed that the entry point and angular deviation over all 76 screw trajectories were 1.40 ± 0.81 mm and 6.70 ± 3.77°, respectively. Angular deviation was significantly higher in the sagittal plane than in the axial plane (P = 0.02). All screw positions were classified as "safe" (100%), showing no neurovascular injury, facet joint violation, or violation of the pedicle wall. CONCLUSIONS:3D virtual planning and 3D-printed patient-specific drill guides appear to be safe and accurate for pedicle and lateral mass screw insertion in the cervical and upper-thoracic spine. The quantitative 3D deviation analyses confirmed that screw positions were accurate with respect to the 3D-surgical plan.Level of Evidence: 4.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Pijpker PAJ,Kraeima J,Witjes MJH,Oterdoom DLM,Vergeer RA,Coppes MH,Groen RJM,Kuijlen JMAdoi
10.1097/BRS.0000000000003747subject
Has Abstractpub_date
2021-02-01 00:00:00pages
160-168issue
3eissn
0362-2436issn
1528-1159pii
00007632-202102010-00007journal_volume
46pub_type
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