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Comparing the Treatment of Congenital Spine Deformity Using Freehand Techniques In Vivo and 3D-Printed Templates In Vitro (Prospective–Retrospective Single-Center Analytical Single-Cohort Study)

Abstract

Introduction

Hemivertebrae excision with local posterior instrumentation is the most common technique for treatment of patients with congenital spine deformity—it is performed at a very young age. We conducted a comparative analysis for accuracy of pedicle screw positioning in infants with congenital scoliosis of the thoracolumbar area inserted using freehand technique in vivo and 3D-printed guiding templates in vitro.

Methods

The study analyzes the results of 10 surgically treated patients with congenital deformity of the thoracolumbar spine due to vertebrae failure of formation. These patients were included in group 1 (in vivo) comprising six boys and four girls with a mean age of 3 years 8 months (2 years 2 months–6 years 8 month). Group 2 (in vitro) consisted of 27 plastic 3D-printed models of congenitally deformed spine of the same 10 patients in which screws were placed using 3D-printed guiding templates. The accuracy of screw position was assessed using computer tomography data performed postoperatively with Gertzbein–Robbins classification.

Results

Results of our study show that screw insertion using 3D-printed guiding templates during surgical treatment of infants with congenital spine deformities is more accurate than using freehand technique (96.3% vs. 78.8% p = 0.011).

Conclusion

The data show that this method of screw insertion is very promising and can be used in surgical treatment of infants with congenital spine deformities.

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Acknowledgements

We thank all participants of the underlying studies.

Funding

This work was supported by Russian Academic Excellence project “5–100” for the Sechenov University, Moscow, Russia. No funding was received for the publication of this article.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Gjumrakch Aliev is employed by GALLY International Biomedical Research LLC. Sergey V. Vissarionov, Dmitriy N. Kokushin, Nikita O. Khusainov, Kirill A. Kartavenko, Marco F. Avila-Rodriguez, Siva G. Somasundaram, Cecil E. Kirkland, and Vadim V. Tarasov have nothing to disclose.

Compliance with Ethics Guidelines

The study protocol was approved by the Turner Scientific and Research Institute for Children’s Orthopaedics (within the Department of Spinal Pathology and Neurosurgery), Pushkin, Saint Petersburg, Russia. All research was performed in accordance with Turner Scientific and Research Institute guidelines and regulations, and the respective authors declare a statement confirming that informed consent was obtained from all of the participants’ parents and/or their legal guardians. In addition to the guidelines described above, the authors of these study dealing with human transplantation research attested that no organs/tissues were procured from prisoners. No animals were used for studies that are the basis of this research. All research on humans was in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national), and with the Helsinki Declaration of 1975, as revised in 2013 (http://ethics.iit.edu/ecodes/node/3931).

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Correspondence to Gjumrakch Aliev.

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Vissarionov, S.V., Kokushin, D.N., Khusainov, N.O. et al. Comparing the Treatment of Congenital Spine Deformity Using Freehand Techniques In Vivo and 3D-Printed Templates In Vitro (Prospective–Retrospective Single-Center Analytical Single-Cohort Study). Adv Ther 37, 402–419 (2020). https://doi.org/10.1007/s12325-019-01152-9

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  • DOI: https://doi.org/10.1007/s12325-019-01152-9

Keywords

  • 3D prototyping
  • Children
  • Congenital scoliosis
  • Guiding templates
  • Hemivertebrae
  • Pedicle screws