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Anatomically Matched Three-Dimensional Printed Guides in Congenital Scoliosis Surgery: A Report of Two Cases
Rayyan Abid1, Bryan O Ren, George H Thompson
1From the Rainbow Babies and Children's Hospital, Case Western Reserve University/University Hospitals, Cleveland, OH (Mr. Abid, Dr. Thompson, and Dr. Hardesty); the Case Western Reserve University School of Medicine, Cleveland, OH (Mr. Abid); and the Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI (Dr. Ren).
Introduction:
Past studies in Europe and Asia have demonstrated the efficacy of three-dimensional (3D) printing technology in patients with complex congenital scoliosis using multisegmental guides. We aimed to evaluate the Firefly pedicle screw navigation guide, a 3D printed, patient- and level-specific, anatomically matched guide, in patients with congenital scoliosis in the United States.
Methods:
We present two patients with complex congenital scoliosis treated with posterior spinal fusion and segmental spinal instrumentation using a 3D printed spine models and level-specific pedicle guides generated from a preoperative CT scan.
Results:
Both patients received notable correction of their coronal curvatures, thoracic kyphosis, and lumbar lordosis. Guides allowed for safe placement of pedicle screws in very small, severely dysplastic pedicles that would be difficult with conventional free hand techniques. Both patients are doing well postoperatively.
Conclusion:
The use of anatomically matched 3D printed guides and a 3D printed model of the spine allowed for safe, relatively rapid anatomical placement of pedicle screws in two difficult cases. In pediatric spinal deformity surgery from congenital causes, challenging curves, or dysplastic pedicles, 3D printing technology is a viable and effective augment to surgical correction.
