Comparison of the 3D-printed operation guide template technique and the free-hand technique for S2-alar-iliac screw plac
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RESEARCH ARTICLE
Open Access
Comparison of the 3D‑printed operation guide template technique and the free‑hand technique for S2‑alar‑iliac screw placement Yonghui Zhao1,2†, Yulong Ma2†, Jinlong Liang2, Haotian Luo1, Xingbo Cai2, Yongqing Xu2 and Sheng Lu1*
Abstract Background: To compare the safety and accuracy of the 3D-printed operation guide template technique and the free-hand technique in the placement of the S2-alar-iliac (S2AI) screw. Methods: We conducted a retrospective analysis of 47 patients undergoing S2AI screw placement in our hospital, divided into the 3D-printed operation guide template group and the free-hand screw placement group. The duration of single S2AI screw placement was documented in all patients. A postoperative CT scan was performed to assess screw placement effectiveness according to the distance from the screw tip to the breach of the cortical bone wall. Results: In total, 42 screws were placed in the guide template group, with an average screw placement duration of 151.6 ± 44.8 s. Screw placement grading was as follows: 40 screws in grade 0, two in grade 1, and none in grades 2 and 3. This grading resulted in excellent and good rates of 95.2% and 100%, respectively. In total, 52 screws were placed in the free-hand group, with an average screw placement duration of 138.3 ± 45.9 s. Screw placement grading was as follows: 42 screws in grade 0, seven in grade 1, three in grade 2, and none in grade 3. This grading resulted in excellent, good and acceptable rates 80.8%, 94.2% and 100%, respectively. Screw placement duration did not significantly differ between the groups (p > 0.05). The excellent rate of screw placement was greater in the guide template group than in the free-hand group (p 0.05). Conclusion: Both techniques can be applied to S2AI screw placement. The 3D-printed guide technique is superior to the free-hand technique in terms of safety and accuracy. Keywords: 3D-printed technique, Operation guide template, Free-hand technique, S2AI screws Introduction Pelvic internal fixation is the key to treating adult spine deformity, severe pelvic inclination, and severe lumbar spondylolisthesis [1]. Due to stress concentrations in the lumbosacral region, unstable distal fixation can lead *Correspondence: [email protected] † Yonghui Zhao and Yulong Ma contributed equally to this work 1 Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China Full list of author information is available at the end of the article
to postoperative complications such as fixation failure and pseudoarticular formation, especially in patients with osteoporosis [2–4]. The pelvic fixation technique is undergoing continuous improvement. In response to the poor stability of the traditional S1 and/or S2 screw fixation, the Galveston technique improved the strength of the fixation, but it was gradually replaced by iliac screw fixation due to its difficulty of operation [5, 6]. Iliac screw fixation
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