Acta Orthopaedica et Traumatologica Turcica
Research Article

Patient-specific three-dimensional printing spine model for surgical planning in AO spine type-C fracture posterior long-segment fixation

1.

Department of Orthopaedic Surgery, Ege University, School of Medicine, İzmir, Turkey

2.

Department of Orthopaedic Surgery, Bozyaka Training and Research Hospital, İzmir, Turkey

3.

Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University, School of Medicine, İzmir, Turkey

4.

Department of Orthopedic Surgery, Dokuz Eylül University, School of Medicine, İzmir, Turkey

AOTT 2022; 56: 138-146
DOI: 10.5152/j.aott.2021.21332
Read: 338 Downloads: 78 Published: 01 March 2022

Objective: The aim of this study was to compare duration of surgery, intraoperative fluoroscopy exposure, blood loss and the accuracy of pedicular screw placement between 3D model-assisted surgery and conventional surgery for AO spinal C-type injuries.

Methods: In this study 32 patients who were admitted with thoracolumbar AO spinal C-type injuries were included. These patients were divided randomly into two groups of 16 where one group was operated on using conventional surgery and the other group was operated on using 3D model-assisted surgery. During surgery, instrumentation time, amount of blood loss and intraoperative fluoroscopy exposure were recorded. Moreover, the status of the screws in the pedicles was assessed as described by Learch and Wiesner’s and regional sagittal angles (RSA) were measured preop and postoperatively.

Results: It was found that there was a statistically significant difference in instrumentation time, blood loss and intraoperative fluoroscopy exposure in the 3D model-assisted surgery group (61.9 ± 4.7 min, 268.4 ± 42.7 ml, 16.3 ± 1.9 times) compared to the conventional surgery group (75.5 ± 11.0 min, 347.8 ± 52.2 mL, 19.7 ± 2.4 times) (t=4.5325, P < 0.0001 and t=4.7109, P < 0.0001 and t=4.4937, P < 0.0001, respectively) Although the screw misplacement rate of the conventional surgery group was higher than that of the 3D model-assisted surgery group, the only statistically significant difference was in the medial axial encroachment (t=5.101 P=0.02) . There was no severe misplacement of pedicle screws in either group. There were no statistically significant differences between postoperative RSA angles and were in both groups restored significantly.

Conclusion: The results of this study have shown us that the 3D model helps surgeons see patients’ pathoanatomy and determine rod lengths, pedicle screw angles and lengths preoperatively and peroparatively, which in turn shortens operative time, reduces blood loss and fluoroscopy exposure.

Level of Evidence: Level I, Therapeutic Study

Cite this article as: Öztürk AM, Süer O, Govsa F, Özer MA, Akçalı Ö. Patient-specific three-dimensional printing spine model for surgical planning in AO spine type-C fracture posterior long-segment fixation. Acta Orthop Traumatol Turc. 2022;56(2):138-146.

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ISSN 1017-995X EISSN 2589-1294