Related Experiment Video
Updated: Jun 19, 2026
Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
Published on: May 24, 2024
Accuracy of thoracolumbar pedicle screw placement using intraoperative CT navigation versus 3D-printed
Sutipat Pairojboriboon1, Korakot Charakorn1, Patcharapit Promoppatum2
1Department of Orthopaedic Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand.
Background:
3D-printed patient-specific pedicle screw guides (3DPSG) may provide accuracy comparable to intraoperative CT navigation (CTNav). Our 3DPSG workflow incorporates a virtual surgical planning (VSP) platform that uses deep-learning algorithms to automatically generate pedicle trajectories from CT data.
Research Design And Methods:
This is a retrospective, single surgeon, single center comparative study of 21 patients undergoing thoracolumbar instrumentation via CTNav (11 patients, 71 screws) and 3DPSG (10 patients, 65 screws). The accuracy was assessed postoperatively using Gertzbein-Robbins and Heary classification systems.
Results:
There were eight men and thirteen women. Gender, BMI, and diagnosis did not differ significantly between the CTNav and 3DPSG groups (p > 0.05). Accuracy was high in both cohorts. By Gertzbein-Robbins, safe placement (grades 0-1) was 97.1% (69/71) with CTNav and 100% (65/65) with 3DPSG. On the Heary system, safe placement (grades 1-2) was 98.6% (70/71) and 100% (65/65), respectively. Malpositions occurred only in the CTNav group (Gertzbein grade 2: 2/71, 2.8%; Heary grade 3: 1/71, 1.4%). Overall accuracy did not differ significantly between groups (Fisher's exact test, p > 0.05).
Conclusions:
3DPSG integrated with VSP platform may be a viable alternative navigation system in middle-income settings where intraoperative CTNav is unaffordable.
