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

European Spine Journal volume 26, pages 1684–1689 (2017)Cite this article

Abstract

Purpose

Accurate implantation of pedicle screw in spinal deformity correction surgeries is always challenging. We have developed a method of pedicle screw placement in severe and rigid scoliosis with a multi-level 3D printing drill guide template.

Methods

From November 2011 to March 2015, ten patients (4 males and 6 females) with severe and rigid scoliosis (Cobb angle >70° and flexibility <30%)were included. Multi-level template was designed and manufactured according to the part (two or three levels) of the most severe deformity. The drill template was then placed on the corresponding vertebral surface. Then, pedicle screws were carefully inserted along the trajectories. The other screws were placed in free hand. After surgery, the positions of the pedicle screws were evaluated by CT scan and graded for validation.

Results

48 screws were implanted using templates, other 104 screws in free hand, and the accuracies were 93.8 and 78.8%, respectively, with significant difference. The deformity correction ratio was 67.1 and 41.2% in coronal and sagittal plane post-operatively, respectively. The average operation time was 234.0 ± 34.1 min, and average blood loss was 557 ± 67.4 ml.

Conclusions

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.

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Acknowledgements

We give special thanks to the technical support of Electromechanical Engineering College, Beijing University of Technology. We also thank Drs. Zhi B Lv, Tao Cui and other members of Department of Radiology, Beijing Ditan Hospital Capital Medical University for their excellent support in supplying CT image material.

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Authors and Affiliations

  1. The Hospital of Shunyi District Beijing, Beijing, China

    Kun Liu

  2. Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015, China

    Qiang Zhang, Xin Li, Changsong Zhao, Xuemin Quan & Rugang Zhao

  3. Third military Medical University, Chongqing, China

    Zongfeng Chen

  4. College of Electromechanical Engineering, Beijing University of Technology, Beijing, China

    Yansheng Li

Authors
  1. Kun Liu
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  2. Qiang Zhang
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  3. Xin Li
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Correspondence to Qiang Zhang.

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Cite this article

Liu, K., Zhang, Q., Li, X. et al. Preliminary application of a multi-level 3D printing drill guide template for pedicle screw placement in severe and rigid scoliosis. Eur Spine J 26, 1684–1689 (2017). https://doi.org/10.1007/s00586-016-4926-1

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  • DOI: https://doi.org/10.1007/s00586-016-4926-1

Keywords

  • Computer-assisted surgery
  • Surgical template
  • 3D printing
  • Scoliosis