Significantly reducing the presurgical preparation time for anterior pelvic fracture surgery by faster creating patient-specific curved plates

BACKGROUND

To shorten the preoperative preparation time, reconstruction plates were designed using the computed tomography (CT)-based three-dimensional (3D) medical imaging surgical planning software OOOPDS. In addition, 3D printing was used to generate curved plates for anterior pelvic fracture surgeries.

METHODS

This study analyzed two groups with the same 21 patients who underwent surgery for traumatic anterior pelvic ring fractures. In Group 1, the direct reconstruction plates were preoperatively contoured according to the anatomical 3D-printed pelvic model. In Group 2, the fixation plates were contoured according to the 3D printed plate templates, which were created based on the simulated plate templates by the OOOPDS software. The processing time, including the 3D printing time for the pelvic models in Group 1, the 3D printing time for the fixation plate templates in Group 2, and the pre-contouring time for the plates in both groups, was recorded.

RESULTS

The mean time of pre-contouring for the curved reconstruction plates in Group 2 was significantly less than in Group 1 (-55 min; P < 0.01). The mean time of 3D printing for the 3D plate template model in Group 2 was significantly less than that for the 3D pelvic model in Group 1 (-869 min; P < 0.01). Experimental results showed that the printing time for the plate pre-contouring and the 3D plate templates could be effectively reduced by approximately 93% and 90%, respectively.

CONCLUSION

This method can shorten the preoperative preparation time significantly.

The validation study of preoperative surgical planning for corrective target in adult spinal deformity surgery with 5-year follow-up for mechanical complications

PURPOSE

We used the Hamamatsu formula as an indicator of correction goals in surgery for adult spinal deformity (ASD). However, it is reported that correction according to Global Alignment and Proportion (GAP) score and the Roussouly algorithm reduces implant-related complications. The purpose of this study was to validate three preoperative plannings for the incidence of complications.

METHODS

Patients who underwent ASD surgery and followed up for 5 years were included. The Hamamatsu formula was also divided into three groups: ideal (I), moderate (M), and under (U). The GAP score was divided into three groups: proportioned (P), moderately disproportioned (MD), and severely disproportioned (SD). Patients who met the postoperative Roussouly classification algorithm were defined as the restored (R) group and those who did not were defined as the non-restored (NR) group. Proximal junctional kyphosis (PJK) and rod fractures were investigated.

RESULTS

In the Hamamatsu formula, there were 51, 108, and 44 patients in Groups I, M, and U, respectively, with no significant differences in their complications. In the GAP score, there were 45, 71, and 87 patients in the P, MD, and SD group, respectively, with no significant differences in their complications. In the Roussouly classification, there were 102 and 101 patients in the R and NR group, respectively, with a significant difference in their complication rate (R/NR = 51%:70%; P = 0.005). PJK was significantly lower in the R group (R/NR = 15%:30%; P = 0.010).

CONCLUSION

Correction according to the Roussouly algorithm is useful for the prevention of mechanical complications, especially PJK.