Maruo K, Arizumi F, Kishima K, Yoshie N, Kusukawa T, Tachibana T. Patient-specific guide systems decrease the major perforation rate of pedicle screw placement in comparison to the freehand technique for adolescent idiopathic scoliosis.
EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023;
32:3105-3112. [PMID:
37289252 DOI:
10.1007/s00586-023-07802-5]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/03/2023] [Accepted: 05/27/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE
This study aimed to compare the accuracy of pedicle screw (PS) placement between a low-profile three-dimensional (3D) printed patient-specific guide system and freehand technique for adolescent idiopathic scoliosis (AIS) surgery.
METHODS
Patients with AIS who underwent surgery between 2018 and 2023 at our hospital were included in the study. The 3D-printed patient-specific guide was used since 2021 (guide group). PS perforation was classified using Rao and Neo's classification (grade 0, no violation; grade 1, < 2 mm; grade 2, 2-4 mm; grade 3, > 4 mm). Major perforations were defined as grades 2 or 3. The major perforation rate of PS, operative time, estimated blood loss (EBL), and correction rate were compared between the two groups.
RESULTS
A total of 576 PSs were inserted in 32 patients (20 patients in the freehand (FH) group and 12 patients in the guide group). The major perforation rate was significantly lower in the guide group than in the FH group (2.1% vs. 9.1%, p < 0.001). Significantly fewer major perforations were observed in the guide group than in the FH group in the upper thoracic (T2-4) region (3.2% vs. 20%, p < 0.001) and lower thoracic (T10-12) region (0% vs. 13.8%, p = 0.001). The operative time, EBL, and correction rate were equivalent between the two groups.
CONCLUSION
The 3D-printed patient-specific guide notably reduced the major perforation rate of PS without increasing EBL and operative time. Our findings indicate that this guide system is reliable and effective for AIS surgery.
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