Clinical effect of individualized 3D printing guide assisted placement of upper cervical pedicle screw

Abstract Objective To investigate the clinical effect of individualized 3D printing guide assisted upper cervical pedicle screw placement. Methods Eighteen patients with upper cervical spine injury requiring surgical treatment were included in our hospital from May 2010 to May 2019. These patients were divided into guide plate assisted screw implantation group (Group A, N = 10) and traditional operation group (Group B, N = 8). All patients were followed up for more than 6 months. Screw implant accuracy, cervical spine JOA score, ASIA score, VAS score, operation time, intraoperative blood loss were compared between the two groups. Result A total of 72 atlantoaxial pedicle screws were implanted, 40 in group A and 32 in group B. The accuracy rate of nail implantation was 97.50% in group A and 81.25% in group B (P < 0.05). The operation time in group A (189.7 ± 16.1 mins) and group B (242.1 ± 23.2 mins), P < 0.05. The intraoperative blood loss in group A (216.0 ± 49.7 ml) and group B (385.0 ± 23.5 ml), P < 0.05. The intraoperative fluoroscopic times was 8.7 ± 1.1 in group A and 30.0 ± 3.3 in group B (P < 0.05). Besides, the JOA, Asia and VAS scores of the two groups at one week after operation and the last follow-up were significantly different from those before operation. One week after operation, the JOA, Asia and VAS scores of group A were significantly better than those of group B, but there was no significant difference between the two groups at the last follow-up. Conclusions individualized 3D printing guide assisted placement of upper cervical pedicle screw can significantly improve the accuracy of screw implantation and postoperative function of patients, reduce the times of X-ray fluoroscopy, operation time, and intraoperative blood loss, which is a safe and effective approach and worthy of clinical promotion.