The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial
In recent years, patient-specific spinal drill guides (3DPGs) have gained widespread popularity. Several studies have shown that the accuracy of screw insertion with these guides is superior to that obtained using the freehand insertion technique, but there are no studies that make a comparison with...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/7/1084 |
| _version_ | 1797405887392907264 |
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| author | Peter A. J. Pijpker Jos M. A. Kuijlen Katalin Tamási D. L. Marinus Oterdoom Rob A. Vergeer Gijs Rijtema Maarten H. Coppes Joep Kraeima Rob J. M. Groen |
| author_facet | Peter A. J. Pijpker Jos M. A. Kuijlen Katalin Tamási D. L. Marinus Oterdoom Rob A. Vergeer Gijs Rijtema Maarten H. Coppes Joep Kraeima Rob J. M. Groen |
| author_sort | Peter A. J. Pijpker |
| collection | DOAJ |
| description | In recent years, patient-specific spinal drill guides (3DPGs) have gained widespread popularity. Several studies have shown that the accuracy of screw insertion with these guides is superior to that obtained using the freehand insertion technique, but there are no studies that make a comparison with computer-assisted surgery (CAS). The aim of this study was to determine whether the accuracy of insertion of spinal screws using 3DPGs is non-inferior to insertion via CAS. A randomized controlled split-spine study was performed in which 3DPG and CAS were randomly assigned to the left or right sides of the spines of patients undergoing fixation surgery. The 3D measured accuracy of screw insertion was the primary study outcome parameter. Sixty screws inserted in 10 patients who completed the study protocol were used for the non-inferiority analysis. The non-inferiority of 3DPG was demonstrated for entry-point accuracy, as the upper margin of the 95% CI (−1.01 mm–0.49 mm) for the difference between the means did not cross the predetermined non-inferiority margin of 1 mm (<i>p</i> < 0.05). We also demonstrated non-inferiority of 3D angular accuracy (<i>p</i> < 0.05), with a 95% CI for the true difference of −2.30°–1.35°, not crossing the predetermined non-inferiority margin of 3° (<i>p</i> < 0.05). The results of this randomized controlled trial (RCT) showed that 3DPGs provide a non-inferior alternative to CAS in terms of screw insertion accuracy and have considerable potential as a navigational technique in spinal fixation. |
| first_indexed | 2024-03-09T03:17:41Z |
| format | Article |
| id | doaj.art-2e29321657e141f6987c07a42951c172 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T03:17:41Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-2e29321657e141f6987c07a42951c1722023-12-03T15:16:33ZengMDPI AGJournal of Personalized Medicine2075-44262022-06-01127108410.3390/jpm12071084The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled TrialPeter A. J. Pijpker0Jos M. A. Kuijlen1Katalin Tamási2D. L. Marinus Oterdoom3Rob A. Vergeer4Gijs Rijtema5Maarten H. Coppes6Joep Kraeima7Rob J. M. Groen8Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands3D-Lab, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsIn recent years, patient-specific spinal drill guides (3DPGs) have gained widespread popularity. Several studies have shown that the accuracy of screw insertion with these guides is superior to that obtained using the freehand insertion technique, but there are no studies that make a comparison with computer-assisted surgery (CAS). The aim of this study was to determine whether the accuracy of insertion of spinal screws using 3DPGs is non-inferior to insertion via CAS. A randomized controlled split-spine study was performed in which 3DPG and CAS were randomly assigned to the left or right sides of the spines of patients undergoing fixation surgery. The 3D measured accuracy of screw insertion was the primary study outcome parameter. Sixty screws inserted in 10 patients who completed the study protocol were used for the non-inferiority analysis. The non-inferiority of 3DPG was demonstrated for entry-point accuracy, as the upper margin of the 95% CI (−1.01 mm–0.49 mm) for the difference between the means did not cross the predetermined non-inferiority margin of 1 mm (<i>p</i> < 0.05). We also demonstrated non-inferiority of 3D angular accuracy (<i>p</i> < 0.05), with a 95% CI for the true difference of −2.30°–1.35°, not crossing the predetermined non-inferiority margin of 3° (<i>p</i> < 0.05). The results of this randomized controlled trial (RCT) showed that 3DPGs provide a non-inferior alternative to CAS in terms of screw insertion accuracy and have considerable potential as a navigational technique in spinal fixation.https://www.mdpi.com/2075-4426/12/7/1084spine surgeryvirtual surgical planning (VSP)3D-printingpatient-specific instrumentationdrill guidescomputer-assisted surgery |
| spellingShingle | Peter A. J. Pijpker Jos M. A. Kuijlen Katalin Tamási D. L. Marinus Oterdoom Rob A. Vergeer Gijs Rijtema Maarten H. Coppes Joep Kraeima Rob J. M. Groen The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial Journal of Personalized Medicine spine surgery virtual surgical planning (VSP) 3D-printing patient-specific instrumentation drill guides computer-assisted surgery |
| title | The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial |
| title_full | The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial |
| title_fullStr | The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial |
| title_full_unstemmed | The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial |
| title_short | The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial |
| title_sort | accuracy of patient specific spinal drill guides is non inferior to computer assisted surgery the results of a split spine randomized controlled trial |
| topic | spine surgery virtual surgical planning (VSP) 3D-printing patient-specific instrumentation drill guides computer-assisted surgery |
| url | https://www.mdpi.com/2075-4426/12/7/1084 |
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