Personalized 3D-printed templates in surgical correction of congenital scoliosis in children

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Abstract
BACKGROUND: One of the most important tasks and challenges of modern vertebrology is determining optimal approaches to the surgical treatment of children with congenital spinal deformities. The relevance of this issue is associated with characteristic features of the disease, including the formation and progression of pathological curvature, rapid and steady deterioration of the spinal column during the child's growth and development, formation of compensatory counter-curves, and a substantial reduction in quality of life and life expectancy in this category of patients. AIM: This work aimed to evaluate the efficacy and accuracy of patient-specific 3D-printed guide templates in the surgical correction of congenital thoracic and lumbar spinal deformities in preschool-aged children. METHODS: A comparative analysis of surgical outcomes was performed in 40 patients (aged 3–7 years) with isolated vertebral formation defects. The patients were divided into two groups: the main group (n = 20), in which pedicle screws were inserted using patient-specific 3D-printed guide templates, and the control group (n = 20), in which the freehand technique was used. The following parameters were assessed: operation duration, extent of fixation, accuracy of screw placement according to the Gertzbein–Robbins scale, and the degree of deformity correction measured using the Cobb method. RESULTS: In the main group, a significant reduction was observed in the time required for pedicle canal preparation (29.7 ± 4.2 s vs. 72.4 ± 6.8 s; p = 0.027) and screw insertion time (36.3 ± 3.5 s vs. 49.2 ± 5.2 s; p = 0.039), as well as a reduction in the extent of fixation (1.4 vs. 2.05 segments; p = 0.013). Accurate pedicle screw placement (grade 0) was achieved in 64.6% of cases in the main group and 23.3% in the control group (p 0.0001). Correction of kyphotic deformity was significantly greater when guide templates were used (p = 0.024). CONCLUSION: The use of patient-specific 3D-printed guide templates improves the accuracy of pedicle screw placement, reduces operation time and the extent of fixation, and ensures the safety and reproducibility of surgical correction of congenital spinal deformities in young children.

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