• Figen Govsa, Mehmet Asim Ozer, Huseyin Biceroglu, Asli Beril Karakas, Sedat Cagli, Cenk Eraslan, and Ahmet Kemal Alagoz.
• Digital Imaging and 3D Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey. Electronic address: figen.govsa@ege.edu.tr.
• World Neurosurg. 2018 Jun 1; 114: e173-e181.

BackgroundTransarticular screw fixation has fatal complications such as vertebral artery (VA), carotid artery, and spinal cord injuries. The landmarks for deciding the entry point for C1 lateral mass screws were clarified by using life-size 3-dimensional (3D) patient-specific spine models.MethodsThis study included a total of 10 patients with C1 fractures. Dual-energy computed tomography (CT) scan data from C1 pre- and postscrewing were modified into 3D patient-specific life-size cervical spine models. The detailed information, such as bony and vascular elements, of 13 separate parameters of C1 was used as an intraoperative reference.Results3D patient-specific models were created preoperatively with the fracture and postoperatively with the screwed vertebrae. After CT scans of the models were measured, the life-size patient-specific models were proven to be individualized. 3D models assisted in determining the fracture locations, pedicle sizes, and positions of the VA. The range of the measurements for ideal point of entry reveals the need for patient-specific intervention was required.Conclusions3D models were used in surgical planning maximizing the possibility of ideal screw position and providing individualized information concerning cervical spinal anatomy. The individualized 3D printing screw insertion template was user-friendly, of moderate cost, and it enabled a radiation-free cervical screw insertion.Copyright © 2018 Elsevier Inc. All rights reserved.

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