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Application of Three-Dimensionally Printed Surgical Guides in Precise Sacral Tumor Excision and Defect Reconstruction
Yansong Liu1,2, Yinghua He1,2, Huanwen Ding3,4
1The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Objective:
Precise resection of sacral tumors remains technically demanding due to their deep anatomical location and close proximity to critical neurovascular structures. Conventional freehand techniques often result in suboptimal resection margins, excessive blood loss, and compromised lumbopelvic stability. This study evaluated whether patient-specific three-dimensional (3D)-printed guiding templates improve surgical accuracy and perioperative outcomes in sacral tumor resection and reconstruction.
Methods:
Nineteen patients undergoing en bloc sacral tumor resection (S1-S3 involvement) with spinopelvic reconstruction (2006-2020) were retrospectively analyzed. Patients were divided into a 3D-printing group (n = 10) and a conventional freehand group (n = 9). In the 3D-printing group, computer-aided design and 3D-printed templates were used for osteotomy, screw placement, and defect reconstruction. Perioperative metrics, surgical accuracy, and complications were compared between groups using Welch's t-test and the Hodges-Lehmann method; oncologic events during follow-up were recorded descriptively.
Results:
The 3D-printing group demonstrated significantly shorter operative time (456.5 ± 62.36 vs. 574.44 ± 114.58 min, p = 0.012), reduced blood loss (4081.40 ± 838.99 vs. 5090.0 ± 1059.67 mL, p = 0.034), and fewer fluoroscopic exposures (4.2 ± 0.79 vs. 10.0 ± 1.58, p < 0.001) compared with the conventional group. Osteotomy accuracy was also superior in the 3D-printing group, with significantly lower angular deviation (3.33° ± 0.45° vs. 6.79° ± 2.16°, p = 0.0012). Postoperative complication rates were comparable (30% vs. 44.4%, p = 0.649), but hospital stay was significantly shorter in the 3D-printing group (10.7 ± 2.71 vs. 18.11 ± 4.01 days, p < 0.001).
Conclusion:
Patient-specific 3D-printed guiding templates enhance precision in sacral tumor excision and reconstruction, improving surgical efficiency and perioperative safety. This computer-assisted, template-guided approach represents a valuable advancement for complex sacral oncologic surgery.
Insights
Patient-specific 3D-printed guides improve sacral tumor surgery precision. This technology reduces operative time, blood loss, and hospital stays, enhancing patient outcomes in complex oncologic resections.
Area of Science:
- Orthopedic Oncology
- Surgical Technology
- Medical Imaging
Background:
- Sacral tumor resection is challenging due to deep location and proximity to vital structures.
- Conventional freehand techniques can lead to incomplete resection and complications.
- Patient-specific 3D-printed templates offer a potential solution for improved surgical accuracy.
Purpose of the Study:
- To evaluate the efficacy of patient-specific 3D-printed guiding templates in sacral tumor resection and reconstruction.
- To compare surgical accuracy and perioperative outcomes between 3D-printed template-guided surgery and conventional freehand techniques.
Main Methods:
- Retrospective analysis of 19 patients with sacral tumors (S1-S3) undergoing resection and reconstruction.
- Comparison of a 3D-printing group (n=10) using custom templates versus a conventional freehand group (n=9).
- Evaluation of operative time, blood loss, fluoroscopic exposure, osteotomy accuracy, complication rates, and hospital stay.
Main Results:
- The 3D-printing group showed significantly shorter operative times (p=0.012), reduced blood loss (p=0.034), and fewer fluoroscopic exposures (p<0.001).
- Superior osteotomy accuracy was observed in the 3D-printing group (p=0.0012).
- Hospital stay was significantly shorter (p<0.001) in the 3D-printing group, with comparable complication rates.
Conclusions:
- Patient-specific 3D-printed guiding templates significantly enhance surgical precision and efficiency in sacral tumor surgery.
- This computer-assisted approach improves perioperative safety and outcomes for complex sacral oncologic procedures.
- 3D-printed templates represent a valuable advancement in the surgical management of sacral tumors.
