3D-printed navigation template in cervical spine fusion: a systematic review and meta-analysis

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REVIEW ARTICLE

3D‑printed navigation template in cervical spine fusion: a systematic review and meta‑analysis Parisa Azimi1 · Taravat Yazdanian2 · Edward C. Benzel3 · Ali Azimi4 · Ali Montazeri5 Received: 28 June 2020 / Revised: 28 June 2020 / Accepted: 5 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Purpose  To explore the effectiveness and advantage of three-dimensional (3D)-printed navigation templates (3DPN-template) assisted in cervical spine fusion (CSF) surgery as compared to conventional surgery. Methods  An electronic literature search in PubMed, Scopus, Web of Science, and Cochrane was conducted for studies of 3DPN-templates in CSF up to May 2020. Outcome measures as the accuracy rate, operation time, intra-operative blood loss, and fluoroscopy used, associated with CSF were extracted. Mean difference based on changes was quantified using Hedges’ g. Results  From 4414 potentially relevant studies, 61 full-text publications were screened. Thirteen studies comprising 330 cases with 1323 screw placements were eligible for inclusion. For template group, pooled estimates were as follows: 97.3% accuracy rate for screw placement, 144.7 min for operating time, 273.6 ml for blood loss, and 3.2 min for fluoroscopic times. A significantly positive difference was observed between the template group compared to control group in terms of accuracy rate of screw placement (Z = 5.3), operation time (Z = 2.41), intra-operative blood loss (Z = 2.64), and fluoroscopic times (Z = 3.64) (all, P value  50% and P value of