Three-Dimensional Printing Technology for Surgical Correction of Congenital Scoliosis Caused by Hemivertebrae.

Published on May 1, 2021in World Neurosurgery1.829
· DOI :10.1016/J.WNEU.2021.01.063
Qiang Tu1
Estimated H-index: 1
(Third Military Medical University),
Qiang Tu2
Estimated H-index: 2
(Southern Medical University)
+ 7 AuthorsJianzhong Xu50
Estimated H-index: 50
(Third Military Medical University)
Source
Abstract
Abstract OBJECTIVE This study aimed to explore the clinical application of 3D printing technology in the surgical treatment of CS due to HV. METHOD Twenty-four patients (11 in the 3D-printing group and 13 in the conventional group) with scoliosis secondary to a single HV were retrospectively reviewed. All of the cases underwent hemivertebrectomy and short-segment fixation. Virtual preoperative planning, operation simulation, and intraoperative application of 3D-printed patient-specific templates were performed in the 3D-printing group. Hemorrhage volume, operation time, transfusion and complications were noted. Radiographic parameters were evaluated preoperatively, postoperatively and at final follow-up. RESULTS All of the patients had different degrees of successfully corrected scoliosis. There was a similar correction of the Cobb angle postoperatively between the two groups. The operation time, blood loss, transfusion, time for the insertion of each screw, accuracy of screw placement, and complication rate in the 3D-printing group were significantly superior to those in the control group. No patient experienced major complications. No significant correction loss or instrument dysfunction was observed during follow-up. CONCLUSION As a viable and effective auxiliary technology, 3D printing makes it possible for surgery to meet both surgeon- and patient-specific requirements. 3D-printed individualized templates will allow surgery for the correction of congenital scoliosis to enter a new stage of personalized precision surgery.
References18
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Introduction Hemivertebrae excision with local posterior instrumentation is the most common technique for treatment of patients with congenital spine deformity—it is performed at a very young age. We conducted a comparative analysis for accuracy of pedicle screw positioning in infants with congenital scoliosis of the thoracolumbar area inserted using freehand technique in vivo and 3D-printed guiding templates in vitro.
2 CitationsSource
#1Wu Zhou (HUST: Huazhong University of Science and Technology)H-Index: 10
#2Tian Xia (HUST: Huazhong University of Science and Technology)H-Index: 5
Last. Guohui Liu (HUST: Huazhong University of Science and Technology)H-Index: 13
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Objective To compare the clinical effect of 3D-printed template technology with X-ray fluoroscopy in assisting surgery for sacroiliac screws placement.
2 CitationsSource
#1Qiang Tu (Third Military Medical University)H-Index: 1
#2Huan-wen Ding (SCUT: South China University of Technology)H-Index: 1
Last. Jianzhong Xu (Third Military Medical University)H-Index: 50
view all 11 authors...
Abstract Objective To report the outcomes of severe kyphoscoliosis secondary to ankylosing spondylitis (AS) corrected with 3D-printing individualized guiding templates. Methods Computer tomography (CT) data of patients with severe kyphoscoliosis secondary to AS were used to reconstruct 3D models of the spine and to develop a surgical plan. An asymmetric wedge pedicle subtraction osteotomy (PSO) was simulated using medical computer design software. Before the actual surgery, continual surgical si...
9 CitationsSource
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 p...
8 CitationsSource
#1Ming Luo (Zhengzhou University)H-Index: 6
#2Wengang WangH-Index: 6
Last. Lei XiaH-Index: 1
view all 4 authors...
BACKGROUND: Three-dimensional (3-D) printing offers the opportunity to create patient-specific guides for pedicle screw placement based on CT-generated models. This technology might allow for more-accurate placement of pedicle screws in patients with severe congenital scoliosis who have rotated vertebrae and small pedicles, but to our knowledge, this premise has not been tested. QUESTIONS/PURPOSES: (1) Is the use of 3-D printing and pedicle guider technology as or more accurate than the use of t...
14 CitationsSource
#1José Miguel Sánchez-Márquez (Hospital Universitario La Paz)H-Index: 4
#2Javier Pizones (Hospital Universitario La Paz)H-Index: 11
Last. Francisco Javier Sánchez Pérez-Grueso (Hospital Universitario La Paz)H-Index: 18
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Abstract Study Design Retrospective case series with comparative analysis. Objective To analyze a consecutive cohort of very young patients operated for congenital scoliosis secondary to a single hemivertebra (HV) and compare thoracolumbar (TL) versus lumbosacral (LS) curve results. Summary of Background Data Despite the published successful results regarding early hemivertebra resection and short fusion for congenital hemivertebrae, literature lacks midterm results, especially in very young chi...
4 CitationsSource
#1Yong HuangH-Index: 3
#2Ganjun FengH-Index: 8
Last. Zhongjie ZhouH-Index: 8
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: The treatment of congenital hemivertebrae in the upper thoracic region is challenging. The objective of this study was to investigate the outcomes of posterior hemivertebral resection for the upper thoracic region. Twenty-one patients diagnosed with upper thoracic congenital scoliosis were included. All of them received hemivertebral resection surgery via the posterior-only approach with at least 2 years of follow-up. The radiographic parameters and Scoliosis Research Society-22 score were ana...
7 CitationsSource
#1Charles E. Mackel (Floating Hospital for Children)H-Index: 6
#2Ajit Jada (Cornell University)H-Index: 8
Last. Steven W. Hwang (Shriners Hospitals for Children)H-Index: 22
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Purpose To provide the reader with a comprehensive but concise understanding of congenital scoliosis
7 CitationsSource
Objectives The objectives of this study were to study the long-term results of one-stage single and multiple level posterior hemivertebrectomies and to find out the safety and efficacy of the procedure.
7 CitationsSource
#1Joshua M. Pahys (Shriners Hospitals for Children)H-Index: 21
#2James T. GuilleH-Index: 26
Abstract Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer ...
23 CitationsSource
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