The 3D Printed Template Assists Accuracy and Safety of Screw Placement in the Treatment of Pediatric Congenital Scoliosis: A Case Control Retrospective Study

Abstract

Background: Three-dimensional (3-D) printed templates are increasingly applied in spinal surgery, but are rarely used in the treatment of congenital scoliosis. This study aimed to evaluate the accuracy and safety of 3D printed template-assisted screw placement in the treatment of congenital scoliosis.Methods: A total of 67 patients with congenital scoliosis treated in our hospital between January 2017 to January 2019 were retrospectively included (mean age= 4.13±2.66 years, range: 2-15) and divided into the template-assistant group (n=34) and the freehand group (n=33) according to the screw placement method. The accuracy rate of pedicle screw placement, surgical outcomes, and incidence of complications were compared between groups.Results: Although the good accuracy (grade 0+ grade 1) rate of pedicle screw placement was comparable between the two groups, the excellent accuracy (grade 0) rate was significantly higher in the template-assistant group than in the freehand group (96.10% vs. 88.64%, P=0.007). The main curve Cobb's angle and Kyphosis' angle significantly decreased after surgery in both groups but without a significant intergroup difference. The template-assistant group had a significantly lower postoperative complication rate than the freehand group (0% vs. 18.18%; P=0.009). The 4 patients with postoperative complications in the freehand group all received revision surgery.Conclusion: The 3D printed templates can improve the excellent accuracy rate of screw placement and reduce postoperative complications in the treatment of congenital scoliosis, thereby improving the therapeutic efficacy.