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. 2022 Jul 6;30(spe1):e248982.
doi: 10.1590/1413-785220223001e248982. eCollection 2022.

NO SIGNIFICANT EFFECT OF 3D MODELLING ON SURGICAL PLANNING IN SPINAL DEFORMITIES

Ortac Guran  1 , Hakan Oflaz  2 , İzge Gunal  3
Affiliations

NO SIGNIFICANT EFFECT OF 3D MODELLING ON SURGICAL PLANNING IN SPINAL DEFORMITIES

Ortac Guran et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objective: To evaluate the effect of 3d printed models on surgical pre-operative planning of complex spinal deformities.

Methods: In our study, five orthopedic surgeons made surgical planning of 5 patients with severe spinal deformity in three conditions: X-ray with computer tomography (X-ray-CT), 3D-computed tomography (3dCT), and 3d printed spine models. Operation plans were examined according to the level and number of instrumentations, osteotomy level, and time required for decision-making.

Results: X-ray-CT, 3dCT, and 3d modeling methods were compared, and no statistically significant difference was observed in the number of screws and osteotomy score to be used in operation. The time required for decision ranking is 3d Model, 3d CT, and Xray-CT.

Conclusions: 3d printed models do not influence the operative plan significantly; however, it reduces surgical planning time at pre-op duration, and those models gave some opportunities to practice with implants on a patient's 3d spine model. Level of Evidence III; Diagnostic Studies - Investigating a Diagnostic Test .

Objetivo: Avaliar o efeito de modelos 3D impressos no planejamento pré-operatório cirúrgico de deformidades complexas da coluna vertebral.

Métodos: Em nosso estudo, 5 cirurgiões ortopédicos fizeram o planejamento cirúrgico de 5 pacientes com deformidade espinhal grave em três condições: raio-X com tomografia computadorizada (raio X-CT), tomografia computadorizada com reconstrução 3D (3dCT) e modelo de coluna vertebral impressa (modelo 3d). Os planos de operação foram examinados de acordo com o nível e número de instrumentos, nível de osteotomia e tempo necessário para a tomada de decisão.

Resultados: Foram comparados os métodos de modelagem de raio X-CT, 3dCT e modelo 3d e nenhuma diferença estatisticamente significativa foi observada no número de parafusos e escore de osteotomia a serem utilizados na operação. O ranking do tempo necessário para a tomada de decisão foi de modelo 3d, 3d CT e raio X-CT.

Conclusões: Os modelos impressos em 3d não influenciam significativamente o plano operatório, porém reduzem o tempo de planejamento cirúrgico no pré-operatório e esses modelos deram algumas oportunidades de praticar com implantes no modelo de coluna 3d do paciente. Nível de evidência III; Estudos de Diagnóstico - Investigando um Teste de Diagnóstico .

Keywords: Biomechanics; Biomedical Engineering; Image-Guided Surgery; Orthopedic Surgery; Simulation.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Workflow for getting 3D model of the spine on a software (Mimics 17). CT imaging data of a human spine as acquired (a) frontal view and (b) sagital view. (c) The collecting system is used as the inner mold. Image segmentation for each slice to get the best solution for each spine. (d) CT images were constructed to the 3D model.
Figure 2
Figure 2. Workflow for building a 3D spine model. (a) The surface modification of the spine model is done by the software (Geomagic 12.0) to ease the 3D printing. (b) spine model is 3D printed with an ultimaker PLA material to obtain 3D surgical evaluation spine model for complex spinal deformities.
See this image and copyright information in PMC

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