• Peter A J Pijpker, Kuijlen Jos M A JMA Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Joep Kraeima, and Chris Faber.
• Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: p.a.j.pijpker@umcg.nl.
• World Neurosurg. 2018 Nov 1; 119: 113-117.

ObjectiveWe have described the use of 3-dimensional (3D) virtual planning and 3D printed patient-specific osteotomy templates in the surgical correction of a complex spinal deformity. Pedicle subtraction osteotomies (PSOs) for the correction of severe spinal deformities are technically demanding procedures with a risk of major complications. In particular, operations of the severely deformed spine call for new, more precise, methods of surgical planning. The new 3D technology could result in new possibilities for the surgical planning of spinal deformities.MethodsWe present the case of severe congenital kyphoscoliosis in a young girl with skeletal dysplasia. A closing wedge-extended PSO was 3D virtual planned using medical computer design software. After the optimal 3D-wedge procedure was planned, individualized osteotomy-guiding templates were designed for translation of the planned PSO to the surgical procedure. During surgery, the PSO was performed using the osteotomy templates. Successful correction of the kyphoscoliosis was realized.ResultsThe kyphosis was successfully reduced using a wedge-shaped extended PSO using preoperative 3D virtual planning, assisted by 3D-printed individualized osteotomy-guiding templates.ConclusionsIn addition to direct translation of the planned PSO for surgery, the 3D planning also facilitated a detailed preoperative evaluation, greater insight into the case-specific anatomy, and accurate planning of the required correction.Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

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