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European Spine Journal

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01-06-2017 | Original Article

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

Authors: Kun Liu, Qiang Zhang, Xin Li, Changsong Zhao, Xuemin Quan, Rugang Zhao, Zongfeng Chen, Yansheng Li

Published in: European Spine Journal | Issue 6/2017

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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Title: Preliminary application of a multi-level 3D printing drill guide template for pedicle screw placement in severe and rigid scoliosis
Authors: Kun Liu
Qiang Zhang
Xin Li
Changsong Zhao
Xuemin Quan
Rugang Zhao
Zongfeng Chen
Yansheng Li
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 6/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4926-1

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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