FIRST EXPERIENCE OF USING PERSONALIZED 3D MODELS IN THE SURGICAL TREATMENT OF THORACOLUMBAR SPINE FRACTURES

Authors

  • Saidumarov Dilshod Mirzaakhmatovich
  • Maksudov Bakhtiyorjon Mukhammadkhonovich
  • Davlatov Bakhodirjon Nabijonovich
  • Kuziev Ortiqsher Ilmiddinovich
  • Ismoilova Muazzam Isroilovna

Keywords:

thoracolumbar spine, pedicle screw fixation, 3D modeling, spinal fractures, VAS, ODI, ASIA

Abstract

To evaluate the effectiveness of patient-specific 3D models in the surgical treatment of thoracolumbar junction fractures. Treatment outcomes of 11 patients (T11–L2) were analyzed using preoperative 3D planning based on MSCT data. The accuracy of pedicle screw placement was assessed according to the Gertzbein–Robbins classification; clinical outcomes were evaluated using VAS, ODI, and ASIA scales. 95.5% of screws corresponded to Grade A–B. Pain intensity decreased (VAS from >8 to 2.5), and ODI improved from 58% to 22% at 6 months. Positive neurological dynamics were observed, and no intraoperative complications were reported. 3D modeling improves the accuracy of screw placement and enhances clinical outcomes.

References

Denis F. The three-column spine and its significance in the classification of acute thoracolumbar spinal injuries // Spine. 1983. Vol. 8(8). P. 817–831. https://doi.org/10.1097/00007632-198311000-00003

Faldini C, Barile F, Cerasoli T, Ialuna M, Viroli G, Manzetti M, Traversari M, Mazzotti A, Ruffilli A. Accuracy of Patient-Specific 3D-Printed Guides for Pedicle Screw Insertion in Spine Revision Surgery: Results of a Retrospective Study. Surg Technol Int. 2022 Nov 15;41:395-401. doi: 10.52198/22.STI.41.NS1642.

Fehlings MG, Tetreault LA, Wilson JR, Kwon BK, Burns AS, Martin AR, Hawryluk G, Harrop JS. A Clinical Practice Guideline for the Management of Acute Spinal Cord Injury: Introduction, Rationale, and Scope. Global Spine J. 2017 Sep;7(3 Suppl):84S-94S. doi: 10.1177/2192568217703387.

Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine (Phila Pa 1976). 1990 Jan;15(1):11-4. doi: 10.1097/00007632-199001000-00004. PMID: 2326693.

Hajnal B, Pokorni AJ, Turbucz M, Bereczki F, Bartos M, Lazary A, Eltes PE. Clinical applications of 3D printing in spine surgery: a systematic review. Eur Spine J. 2025 Feb;34(2):454-471. doi: 10.1007/s00586-024-08594-y. Epub 2025 Jan 7.

Kuklo T.R., Polly D.W., Owens B.D., Zeidman S.M., Chang A.S., Klemme W.R. Measurement of pedicle morphology in the thoracic spine // Spine. 2000. Vol. 25(10). P. 1186–1190. https://doi.org/10.1097/00007632-200005150-00015

Liu Z, Wang Y, Xu N, et al. Computer design combined with 3D printing template for spinal orthopedics can improve surgical accuracy and correction effect. Chin J Tissue Eng Res. 2021;25(12):1826-1830.

Mulyadi R, Hutami WD, Suganda KD, Khalisha DF. Risk of neurologic deficit in medially breached pedicle screws assessed by computed tomography: a systematic review. Asian Spine J. 2024 Dec;18(6):903-912. doi: 10.31616/asj.2024.0325.

Nie H, Niu G, Zhou G, Liu T, Chen H, Li C. [Clinical application of three-dimensional printing technique combined with thoracic pedicle screw track detector in thoracic pedicle screw placement]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 May 15;35(5):586-592. Chinese. doi: 10.7507/1002-1892.202012016.

Panjabi M.M. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement // Journal of Spinal Disorders. 1992. Vol. 5(4). P. 383–389. https://doi.org/10.1097/00002517-199212000-00001

Ribera-Navarro, A., Shenoy, R., Cunningham, G., Vakharia, V., Gibson, A., Moazen, M., & Kalaskar, D. M. (2021). Patient-Specific 3D-Printed Surgical Guides for Pedicle Screw Insertion: Comparison of Different Guide Design Approaches. Journal of 3D Printing in Medicine, 5(2), 71–82. https://doi.org/10.2217/3dp-2021-0002

Sugawara T, Kaneyama S, Higashiyama N, Sumi M. Safe and accurate pedicle screw insertion using patient-specific 3D-printed templates: technical note and clinical results.Spine Surg Relat Res. 2019;3(1):11–18.doi:10.22603/ssrr.2018-0012

Sugawara T., Kaneyama S., Matsumoto T., Kato Y., Hirose Y., Sumi M., et al. 3D patient-specific drill guide templates for thoracic pedicle screws // Spine. 2014. Vol. 39(20). P. E1235–E1241. https://doi.org/10.1097/BRS.0000000000000512

Tang J, Zhu Z, Sui T, Kong D, Cao X. Position and complications of pedicle screw insertion with or without image-navigation techniques in the thoracolumbar spine: a meta-analysis of comparative studies. J Biomed Res. 2014 May;28(3):228-39. doi: 10.7555/JBR.28.20130159.

Vaccaro A.R., Rihn J.A., Anderson D.G., Patel A.A., Sasso R.C., Hilibrand A.S. Surgical management of thoracolumbar spine fractures // Journal of the American Academy of Orthopaedic Surgeons. 2013. Vol. 21(8). P. 471–482. https://doi.org/10.5435/JAAOS-21-08-471

Wang L, et al. Application of 3D-printed navigation templates in the treatment of atlantoaxial instability. Sci Rep. 2019;9(1):17112.

Zhang G, et al. Clinical application of 3D printing technology in the treatment of complex spinal fractures. J Orthop Surg Res. 2020;15(1):402.

Zileli M, Sharif S, Fornari M. Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations. Neurospine. 2021 Dec;18(4):704-712. doi: 10.14245/ns.2142418.209. Epub 2021 Dec 31.

Published

2026-05-13