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Vet Comp Orthop Traumatol 2022; 35(06): 381-389
DOI: 10.1055/s-0042-1750433
Original Research

Accuracy of Lumbosacral Pedicle Screw Placement in Dogs: A Novel 3D Printed Patient-Specific Drill Guide versus Freehand Technique in Novice and Expert Surgeons

Jos J. Bongers 
1   School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
,
Nathan Wilkinson
2   Axia 3D Design (currently Nexus Engineering & Design Ltd), Napier, New Zealand
,
Manabu Kurihara
3   Cummings School of Veterinary Medicine at Tufts University, Crafton, United States
,
Janis P. Bridges
4   Massey University School of Veterinary Science, Palmerston North, New Zealand
,
Wendy Baltzer
5   University of Sydney, School of Veterinary Science, Sydney, New South Wales, Australia
,
Andrew J. Worth 
4   Massey University School of Veterinary Science, Palmerston North, New Zealand
› Author Affiliations Funding Funding for this project was provided by the Massey University Working Dog Centre, Palmerston North, New Zealand.
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Abstract

Objective The aim of this study was to compare the accuracy of pedicle screw placement at the canine lumbosacral junction using a novel unilateral three-dimensional printed patient-specific guide (3D-PSG) versus a freehand drilling technique. Additionally, accuracy of screw placement between a novice and an experienced surgeon was determined.

Study Design Preoperative computed tomography images from 20 lumbosacral cadaveric specimens were used to design a novel unilateral 3D-PSG for the L7 and sacral vertebrae which was printed in acryl-nitrile butadiene styrene plastic. A novice and an expert surgeon each placed 3.5mm cortical screws in 10 cadavers; on the left using the unilateral 3D-PSG and by the freehand (anatomic landmark) technique on the right.

Results Sixty screws were placed using the unilateral 3D-PSG and 60 using the freehand technique. There was no statistical difference in accuracy for the comparison between methods performed by the expert (p = 0.679) and novice (p = 0.761) surgeon, nor between an expert and novice surgeon overall (p = 0.923). Unexpectedly, the use of a unilateral 3D-PSG increased variability for the expert surgeon in our study (p = 0.0314).

Conclusion Using a novel unilateral 3D-PSG did not improve the accuracy of screw placement for lumbosacral stabilization by a novice surgeon compared with an expert surgeon in lumbar spine surgery. This may reflect a suboptimal PSG design.

Keywords

accuracy - 3D printed - lumbosacral - screw - patient-specific


Publication History

Received: 25 January 2021

Accepted: 04 May 2022

Article published online:
10 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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