3D-Printed Guide Plate System-Assisted Thoracolumbar Kyphosis Osteotomy: A Technical Case Series

OBJECTIVE: This paper reports a new three-dimensional (3D)-printed osteotomy guidance system to assist thor-acolumbar kyphosis osteotomy and describe the guide plate design, surgical procedure, and short-term clinical results. -METHODS: The computer-aided design software re-constructs the 3D model of the spinal deformity region using the computed tomography data of the patient and plans the correction angle according to the deformity. The guide plate design described in previous experimental studies was used and optimized before clinical applica-tion. The lamina positioning, lamina osteotomy, and verte-bral osteotomy guides were designed, and three 3D guides with different functions were used to assist osteotomy. -RESULTS: Seven patients successfully underwent osteotomy under the guidance of a 3D guide plate. Kyphosis was corrected to different degrees without serious com-plications. At the last follow-up, the back pain and nerve function of 7 patients were improved to varying degrees and the internal fixation without displacement and fracture. -CONCLUSIONS: The preliminary clinical application of the new 3D osteotomy guidance system shows that it provides an effective connection between the guide plates and a clinically operative visual field. The use of a 3D guide plate system for positioning and guidance is helpful to complete preoperative planning of anterior and middle column vertebral body osteotomy. However, the efficacy of this method should be compared to that of the free-hand technique with long-term follow-up.