Role of 3D Printing in Preoperative Planning for Spine Surgery: A Scoping Review

Three-dimensional (3D) printing has emerged as a useful adjunct in spine surgery, particularly for preoperative planning, surgical rehearsal, education, patient communication, navigation template development, and selected patient-specific applications. This scoping review maps the available literature on the use of 3D printing in preoperative planning and related applications for spine surgery. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines using PubMed, Google Scholar, Embase, SCOPUS, and Web of Science. Databases were searched from inception through September 2025. Seventy-one unique articles were included: 12 comparative studies; 20 non-comparative clinical, technical, simulation, or education-focused studies; and 39 additional case reports or technical notes. The retrospective studies were further stratified into 20 non-comparative retrospective studies and 12 comparative retrospective studies evaluating 3D printing-assisted approaches against control or comparator approaches. Across the included literature, 3D printing was most commonly used for anatomical visualization, surgical rehearsal, screw trajectory planning, navigation template or drill guide development, patient education, trainee education, intraoperative reference, and selected custom implant or prosthetic applications. Several comparative studies reported favorable study-level findings associated with 3D printing, including reported improvements in screw placement accuracy or acceptable placement, operative duration, blood loss, fluoroscopy exposure, and complications; however, these outcomes were reported inconsistently and were not pooled quantitatively. Reported limitations included upfront production costs, prolonged preparation time, imaging and segmentation requirements, limited soft-tissue or biomechanical realism, and the need for specialized software, equipment, and personnel. Overall, 3D printing appears to be a promising adjunct for selected spine surgery applications, but current evidence remains largely retrospective, heterogeneous, and descriptive. Prospective, multicenter, controlled studies with standardized outcome measures, cost-effectiveness analyses, and longer follow-up are needed before 3D printing can be recommended as a standard component of preoperative planning in spine surgery.