Emerging Evidence for Three-Dimensional (3D)-Printed Guide Templates in Cervical Spine Trauma Surgery: A Scoping...

Cervical spine fractures are complex injuries that require precise surgical fixation. Conventional freehand pedicle screw placement is associated with prolonged operative time, higher blood loss, and repeated fluoroscopy. Three-dimensional (3D) printing (3DP) offers customized patient-specific templates that may improve safety and efficiency in such cases. This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were searched for comparative studies evaluating 3DP-assisted surgery versus conventional methods in cervical spine fractures. Two reviewers independently screened, extracted data, and assessed study quality using the Methodological Index for Non-Randomized Studies (MINORS) tool. A random-effects model was used for pooled analyses, and heterogeneity was assessed with the I² statistic. Four retrospective comparative studies involving 189 patients were included. Compared with conventional freehand techniques, 3DP-assisted surgery significantly reduced operative time (mean difference: -32.3 minutes; 95%CI -38.6 to -26.0), intraoperative blood loss (mean difference: -121.6 ml; 95%CI -149.0 to -94.1), and fluoroscopy frequency (mean difference: -3.8 shots; 95%CI -4.6 to -2.9). Pain scores at 12 months were also slightly lower in the 3DP group. Heterogeneity ranged from low to moderate, and no major publication bias was identified. 3DP-assisted cervical spine surgery appears to improve operative efficiency and reduce intraoperative burden compared with conventional techniques. These findings represent early, technology-focused evidence supporting the feasibility of 3D-printed guide templates in cervical spine trauma. Given the heterogeneity of injury patterns and anatomical regions, the results should be interpreted as hypothesis-generating rather than definitive.