• Ahmet Onur Akpolat, Bekir Eray Kilinc, Mehmet Fatih Aksay, Onur Gultekin, Semih Ak, Erkan Akgun, and Mehmet Bulent Balioglu.
• Orthopedics Surgery and Traumatology Department, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey. Electronic address: onurakpolat@hotmail.com.
• World Neurosurg. 2021 Mar 1; 147: e559-e564.

ObjectiveTo evaluate the effect of pedicle angle measurement in preoperative axial computed tomography in patients with adolescent idiopathic scoliosis (AIS) on correct thoracic screw placement in free-hand technique on 3-dimensional printing AIS models.MethodsIn this study, 14 3-dimensional spine models with a scale of 1:1, including the entire spine of a patient with Lenke type 1 curve, were used. Group 1 included screwing applications with unknown pedicle axial angles, and group 2 included screwing applications with known pedicle axial angles. The number and direction of screws in malposition were recorded. In addition, medial encroachment distances of the screws were classified as 0-4 mm and greater than 4 mm, and lateral encroachment distances were classified as 0-6 mm and greater than 6 mm. Evaluation parameters were compared statistically between the groups.ResultsThe number of screws in the correct position in group 1 was lower than that in group 2 (P < 0.05). The medial and lateral malposition rate in group 1 was greater than that in group 2 (P < 0.05). The medial encroachment rate of 4 mm and greater and lateral encroachment rate of 6 mm and greater in group 1 was greater than that in group 2 (P < 0.05). The medial encroachment rate of 0-4 mm and lateral encroachment rate of 0-6 mm were similar between groups 1 and 2 (P > 0.05).ConclusionsMeasurement of pedicle axial axes of preoperative thoracic vertebrae on computed tomography in patients with AIS offers more reliable screwing in free-hand technique.Copyright © 2021 Elsevier Inc. All rights reserved.

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