Novel design for a customized, 3D-printed surgical template for thoracic spinal arthrodesis

Int J Med Robot. 2019 Aug;15(4):e2005. doi: 10.1002/rcs.2005. Epub 2019 May 22.

Abstract

Background: The integration of computer-aided design/computer-aided manufacturing (CAD/CAM) tools and medicine is rapidly developing for designing medical devices. A novel design for a 3D-printed patient-specific surgical template for thoracic pedicle screw insertion, using a procedure based on reverse engineering, is presented.

Methods: The surgeon chooses the entry point on the vertebra. The optimal insertion direction and the size of the screws are defined via an algorithm on the basis of a patient-specific vertebra CAD model. The template features an innovative shape for a comfortable and univocal placement and a novel disengaging device.

Results: Three spinal fusions were performed to test the template. Excellent results were achieved in terms of the accuracy of the screw positioning, reduction in surgery duration, and number of X-rays.

Conclusions: A novel design for a customized, 3D-printed surgical template for thoracic spinal arthrodesis was presented, and improvements in terms of precision, duration, and safety were achieved without changing the standard procedure.

Keywords: 3D imaging; X-ray minimization; additive manufacturing; bone; computer-assisted surgery; imaged guided surgery; in vivo; modelling; pedicle screw fixation; screw direction optimization; spine; surgical template; thoracic; thoracic spinal arthrodesis.

MeSH terms

  • Algorithms
  • Cervical Vertebrae / surgery
  • Humans
  • Imaging, Three-Dimensional / methods
  • Pedicle Screws*
  • Printing, Three-Dimensional*
  • Radiography
  • Spinal Fusion / instrumentation*
  • Spinal Fusion / methods*
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods
  • Thoracic Vertebrae / surgery*
  • Tomography, X-Ray Computed