A 3D-printed Personalized, Combined, Modular Pedicle Subtraction Osteotomy Guide Plate System: An Experimental Study.

Abstract

Experimental study. The goal of this study was to develop a threedimensional (3D)-printed pedicle subtraction osteotomy (PSO) guide plate system. A 3D model and postoperative computed tomography (CT) data were used to evaluate the accuracy of osteotomy with this system. The key to the success of spinal orthopedic treatment is an effectively performed osteotomy. A 3D-printed osteotomy plate can be used for preoperative surgical planning. Due to the anatomical complexity of the spinal region, the clinical application of 3D-printed osteotomy plates remains challenging. The CT scans of 10 patients with thoracolumbar spinal deformities were obtained in the digital imaging and communication in medicine (DICOM) format. The diseased vertebrae and adjacent vertebrae were reconstructed and reduced by computer- aided design software, and an osteotomy plate was designed for the diseased vertebrae. The 3D-printed spinal model and osteotomy plate were used to simulate the operation for PSO. After the operation, the vertebral body treated by osteotomy underwent a CT scan, and the findings were compared with the preoperative design to evaluate the osteotomy accuracy. The new 3D guide plate and spine model were used to successfully simulate 10 cases of PSO, and the comparison of the preoperative and postoperative states indicated that the osteotomy outcomes were excellent. The new 3D-printed PSO guide plate system can be used for preoperative osteotomy planning and demonstrates good accuracy. The results can be used to develop 3D-printed plans for PSO in clinical practice.