Lumbar and sacral pedicle screw placement using a template does not improve the midterm pain and disability outcome in comparison with free-hand method

Merc, Matjaž; Rečnik, Gregor; Krajnc, Zmago

doi:10.1007/s00590-017-1904-1

Cited by 15 publications

(12 citation statements)

References 25 publications

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“…Then, 4 animal studies and 4 cadaver specimen studies were excluded from the 21 studies that met the inclusion criteria. Finally, 13 eligible trials [14,[17][18][19][20][21][22][23][24][25][26][27][28] were included in this meta-analysis. The flow diagram for the literature selection is shown in Fig.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Six of the seven randomized controlled trials [14,17,18,[22][23][24] had a low risk of performance bias due to the random sequence generation method, and only one study [27] had a high risk due to selection bias. Five studies [18,[22][23][24]27] had a high risk of performance bias with due to the method of blinding the participants and personnel, and the other studies had an unclear risk [14,17]. One study [24] had a high risk of detection bias, and another study [22] had a high risk of attrition bias.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Five studies [18,[22][23][24]27] had a high risk of performance bias with due to the method of blinding the participants and personnel, and the other studies had an unclear risk [14,17]. One study [24] had a high risk of detection bias, and another study [22] had a high risk of attrition bias. As illustrated in Fig.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…There are different pedicle shapes, and 3D printing technology can produce many different drill guide templates that flexibly adjust the angle of the screw [7,20,32]. Though it improves the accuracy rate of the pedicle screw, the application of the technique is not more effective in reducing pain and disability after midterm follow-up in comparison with the free-hand technique [24].…”

Section: Discussionmentioning

confidence: 99%

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Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

Xie

et al. 2020

J Orthop Surg Res

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Background: Many surgeons believe that the use of a 3D-printed drill guide template shortens operative time and reduces intraoperative blood loss compared with those of the free-hand technique. In this study, we investigated the effects of a drill guide template on the accuracy of pedicle screw placement (the screw placed completely in the pedicle), operative time, and intraoperative blood loss. Materials/Methods: We systematically searched the major databases, such as Medline via PubMed, EMBASE, Ovid, Cochrane Library, and Google Scholar, regarding the accuracy of pedicle screw placement, operative time, and intraoperative blood loss. The χ 2 test and I 2 statistic were used to examine heterogeneity. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the accuracy rate of pedicle screw placement, and weighted mean differences (WMDs) with 95% CIs were utilized to express operative time and intraoperative blood loss. Results: This meta-analysis included 13 studies (seven randomized controlled trials and six prospective cohort studies) involving 446 patients and 3375 screws. The risk of research bias was considered moderate. Operative time (WMD = − 20.75, 95% CI − 33.20~− 8.29, P = 0.001) and intraoperative blood loss (WMD = − 106.16, 95% CI − 185.35 − 26.97, P = 0.009) in the thoracolumbar vertebrae, evaluated by a subgroup analysis, were significantly different between groups. The 3D-printed drill guide template has advantages over the free-hand technique and improves the accuracy of pedicle screw placement (OR = 2.88; 95% CI, 2.39~3.47; P = 0.000). Conclusion: The 3D-printed drill guide template can improve the accuracy rate of pedicle screw placement, shorten operative time, and reduce intraoperative blood loss.

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Section: Literature Search Resultsmentioning

confidence: 99%

Section: Literature Search Resultsmentioning

confidence: 99%

Section: Literature Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

Xie

et al. 2020

J Orthop Surg Res

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“…Éltes et al (2016) [32] created a template for sacrum with two screw-guiding structures using photoactive 3D printing technology. Merc et al (2017) [33] concluded that although the template for sacral pedicle screw placement does not reduce pain and disability than the free-hand technique, however, does reduce the incidence of cortex perforation.…”

Section: Introductionmentioning

confidence: 99%

Novel Procedure for Designing and 3D Printing a Customized Surgical Template for Arthrodesis Surgery on the Sacrum

Naddeo

Cappetti

et al. 2018

Symmetry

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Abstract:In this article, the authors propose a novel procedure for designing a customized 3D-printed surgical template to guide surgeons in inserting screws into the sacral zone during arthrodesis surgeries. The template is characterized by two cylindrical guides defined by means of trajectories identified, based on standard procedure, via an appropriate Computer-Aided-Design (CAD)-based procedure. The procedure is based on the definition of the insertion direction by means of anatomical landmarks that enable the screws to take advantage of the maximum available bone path. After 3D printing, the template adheres perfectly to the bone surface, showing univocal positioning by exploiting the foramina of the sacrum, great maneuverability due to the presence of an ergonomic handle, as well as a break system for the two independent guides. These features make the product innovative. Thanks to its small size and the easy anchoring, the surgeon can simply position the template on the insertion area and directly insert the screws, without alterations to standard surgical procedures. This has the effect of reducing the overall duration of the surgery and the patient's exposure to X-rays, and increasing both the safety of the intervention and the quality of the results.

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3D-Druck in der Wirbelsäulenchirurgie – Update

2022

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Lumbar and sacral pedicle screw placement using a template does not improve the midterm pain and disability outcome in comparison with free-hand method

Cited by 15 publications

References 25 publications

Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

Novel Procedure for Designing and 3D Printing a Customized Surgical Template for Arthrodesis Surgery on the Sacrum

3D-Druck in der Wirbelsäulenchirurgie – Update

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