Abstract
ObjectivesThe present study aimed to compare patients in whom an operation plan was prepared before surgery using the three-dimensional (3D) modeling technology with the application of freehand screws using magnetic resonance imaging (MRI) and computed tomography (CT) scan images.MethodsThe printings and modelings were established in the Training and Research Center. Of 40 patients, 20 underwent surgery with 3D printing (Group 1) and 20 with the freehand technique (Group 2). The surgeries were performed by the same surgeons. Moreover, 5-mm pedicle screws were located in 122 vertebrae in 20 patients in whom 3D modeling was used and in 124 vertebrae in 20 patients in whom this modeling technique was not used.ResultsThe mean time of screw insertion was 2.9 ± 1.2 minutes in the experimental group and 4.7 ± 2.3 minutes in the control group. While the mean amount of bleeding was 7.4 ± 4.1 ml in the experimental group, it was found to be 39.6 ± 14.2 ml in the control group. When the locations of the screws in the experimental group were evaluated, it was seen that 106 (86.9%) screws were ‘excellent’ and 16 (13.1%) screws were ‘good.’ When the placement of 124 pedicle screws in the control group was evaluated, it was found that 100 (80.6%) screws were ‘excellent,’ 20 (17.8%) screws were ‘good,’ and two (1.6%) screws were ‘poor.’ConclusionThe use of the improved 3D technology in the neurosurgery field is advantageous for surgeons, as it decreases the preoperative preparation phase, length of operation, and risk of complications.
Highlights
Lumbar degenerative scoliosis is the curvature of the lumbar spine after it completes its development [1]
Curvatures of more than 10° on the anteroposterior radiographs of the spine of adult patients are called "adult lumbar scoliosis." The prevalence of adult lumbar scoliosis varies between 8.3%-68% [2]
The use of instruments is common in the surgical treatment of degenerative rotascoliosis, this technique is accompanied by prolonged operation times, increased blood loss during surgery, and increased risk of neurological complications
Summary
Lumbar degenerative scoliosis is the curvature of the lumbar spine after it completes its development [1]. A pedicle screw is one of the most important tools in lumbar degenerative scoliosis treatment [4]. Because the pedicle is adjacent to the spinal canal and surgery is conducted in a narrow anatomic area, the accuracy and safety of using transpedicular screws are essential to prevent complications. Surgeons can make preoperative plans with direct radiography, computed tomography, and spine models produced by three-dimensional (3D) printers for patients who are planned to undergo spinal surgery [8]. With the support of three-dimensional printers, radiological images were transformed into concrete objects, and it was observed that the duration of surgery was shortened with preoperative planning [9]. Models produced with 3D printers supported by radiological imaging allow both doctors and patients to understand the existing pathology and to make a preoperative plan [8].
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