• World Neurosurg · May 2021

    The Development of novel 2-in-1 patient specific, 3D-printed laminectomy guides with integrated pedicle screw drill guides.

    • Andrew Kanawati, Rodrigues FernandesRenan JoseRJLondon Health Science Centre, Victoria Hospital-London, Ontario, Canada., Aaron Gee, Jennifer Urquhart, Fawaz Siddiqi, Kevin Gurr, Christopher S Bailey, and Parham Rasoulinejad.
    • London Health Science Centre, Victoria Hospital-London, Ontario, Canada; Westmead Hospital, Sydney, NSW, Australia. Electronic address: andrewkanawati@yahoo.com.au.
    • World Neurosurg. 2021 May 1; 149: e821-e827.

    ObjectiveTo determine if 2-in-1 patient-specific laminectomy and drill guides can be safely used to perform laminectomy and pedicle screw insertion.MethodsThis was a cadaveric study designed to test novel 2-in-1 patient-specific laminectomy guides, with modular removable pedicle screw drill guides. Three-dimensional (3D) printing has not been applied to laminectomy. This cadaveric study tests novel 2-in-1 patient-specific laminectomy guides, with modular removable pedicle screw drill guides. Computed tomography (CT) scans of 3 lumbar spines were imported into 3D Slicer. Spinal models and patient-specific guides were created and 3D printed. The bones were cleaned to visualize and record the under surface of the lamina during laminectomy. Pedicle screws and laminectomies were performed with the aid of patient-specific guides. CT scans were performed to compare planned and actual screw and laminectomy positions.ResultsThirty screws were inserted in 15 lumbar vertebrae by using the integrated 2-in-1 patient-specific drill guides. There were no cortical breaches on direct examination, or on postoperative CT. Digital video analysis revealed the burr tip did not pass deep to the inner table margin of the lamina in any of the 30 laminectomy cuts. Average surgical time was 4 minutes and 46 seconds (standard deviation, 1 min 38 sec).ConclusionsThis study has explored the development of novel 2-in-1 patient-specific, 3D-printed laminectomy guides with integrated pedicle screw drill guides, which are accurate and safe in the laboratory setting. These instruments have the potential to simplify complex surgical steps, and improve accuracy, time, and cost.Copyright © 2021 Elsevier Inc. All rights reserved.

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