• Xin Xin, Xinxin Liu, Yanan Zhu, Jiawei Li, Chen Yue, and Dingjun Hao.
• Ankang Center Hospital, Department of Orthopaedics, Ankang, Shaanxi Province, P.R. China. Electronic address: xcfxcy1981@163.com.
• World Neurosurg. 2023 May 1; 173: 283328-33.

ObjectiveThis paper reports a new three-dimensional (3D)-printed osteotomy guidance system to assist thoracolumbar kyphosis osteotomy and describe the guide plate design, surgical procedure, and short-term clinical results.MethodsThe computer-aided design software reconstructs the 3D model of the spinal deformity region using the computed tomography data of the patient and plans the correction angle according to the deformity. The guide plate design described in previous experimental studies was used and optimized before clinical application. The lamina positioning, lamina osteotomy, and vertebral osteotomy guides were designed, and three 3D guides with different functions were used to assist osteotomy.ResultsSeven patients successfully underwent osteotomy under the guidance of a 3D guide plate. Kyphosis was corrected to different degrees without serious complications. At the last follow-up, the back pain and nerve function of 7 patients were improved to varying degrees and the internal fixation without displacement and fracture.ConclusionsThe preliminary clinical application of the new 3D osteotomy guidance system shows that it provides an effective connection between the guide plates and a clinically operative visual field. The use of a 3D guide plate system for positioning and guidance is helpful to complete preoperative planning of anterior and middle column vertebral body osteotomy. However, the efficacy of this method should be compared to that of the free-hand technique with long-term follow-up.Copyright © 2023 Elsevier Inc. All rights reserved.

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