• Peter A J Pijpker, Joep Kraeima, Max J H Witjes, OterdoomD L MarinusDLMUniversity of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands., Rob A Vergeer, Maarten H Coppes, GroenRob J MRJMUniversity of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands., and KuijlenJos M AJMAUniversity of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands..
• University of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, The Netherlands.
• Spine. 2021 Feb 1; 46 (3): 160168160-168.

Study DesignSingle-center retrospective case series.ObjectiveThe 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 DataPosterior 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.MethodsA 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.ResultsThe 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.Conclusions3D 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.Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.

22 keywords...

hide…