Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study
Abstract Background Most 3D-printed guiding templates require dissection of soft tissues to match the corresponding surfaces of the guiding templates. This study sought to explore the accuracy and acceptability of the novel 3D printed individualized guiding templates based on cutaneous fiducial mark...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-024-02402-6 |
| _version_ | 1797209564781740032 |
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| author | Xingguang Tao Fei Lyu Kapil Sugand Kaihua Zhou Huixiang Wang |
| author_facet | Xingguang Tao Fei Lyu Kapil Sugand Kaihua Zhou Huixiang Wang |
| author_sort | Xingguang Tao |
| collection | DOAJ |
| description | Abstract Background Most 3D-printed guiding templates require dissection of soft tissues to match the corresponding surfaces of the guiding templates. This study sought to explore the accuracy and acceptability of the novel 3D printed individualized guiding templates based on cutaneous fiducial markers in minimally invasive screw placement for pelvic fractures. Methods The printed template was tested on five high-fidelity biomimetic phantom models of the bony pelvis and its surrounding soft tissues as well as on two fresh frozen cadavers. Four cutaneous fiducial markers were transfixed on each phantom model prior to performing CT scans to reconstruct their 3D models. Personalized templates for guiding screw insertion were designed based on the positions of the fiducial markers and virtually planned target screw channels after scanning, followed by 3D printing of the guide. Phase 1 consisted of five expert surgeons inserting one anterograde supra-pubic screw and one sacroiliac screw percutaneously into each phantom model using the 3D-printed guide. The deviation of screw positions between the pre-operative planned and post-operative actual ones was measured after registering their 3D modelling. A Likert scale questionnaire was completed by the expert surgeons to assess their satisfaction and acceptability with the guiding template. Phase 2 consisted of repeating the same procedures on the fresh frozen cadavers in order to demonstrate face, content and concurrent validity. Results In Phase 1, all ten screws were successfully implanted with the assistance of the guiding template. Postoperative CT scans confirmed that all screws were safely positioned within the bony pelvic channels without breaching the far cortex. The mean longitudinal deviation at the bony entry point and screw tip between the pre-operative planned and post-operative actual screw paths were 2.83 ± 0.60 mm and 3.12 ± 0.81 mm respectively, with a mean angular deviation of 1.25 ± 0.41°. Results from the Likert questionnaire indicated a high level of satisfaction for using the guiding template among surgeons. In Phase 2, results were similar to those in Phase 1. Conclusions The 3D-printed guiding template based on cutaneous fiducial markers shows potential for assisting in the accurate insertion of percutaneous screws in the pelvis. |
| first_indexed | 2024-04-24T09:56:43Z |
| format | Article |
| id | doaj.art-6fde8b5cbe1e4350b0a1e635663ebcc9 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-24T09:56:43Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-6fde8b5cbe1e4350b0a1e635663ebcc92024-04-14T11:06:39ZengBMCBMC Surgery1471-24822024-04-0124111110.1186/s12893-024-02402-6Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver studyXingguang Tao0Fei Lyu1Kapil Sugand2Kaihua Zhou3Huixiang Wang4Department of Orthopedics, Qingpu Branch of Zhongshan Hospital, Fudan UniversityDepartment of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou UniversityRoyal National Orthopaedic HospitalDepartment of Orthopedics, Qingpu Branch of Zhongshan Hospital, Fudan UniversityDepartment of Orthopedics, Shanghai Sixth People’s Hospital Affliated to Shanghai Jiao Tong University School of MedicineAbstract Background Most 3D-printed guiding templates require dissection of soft tissues to match the corresponding surfaces of the guiding templates. This study sought to explore the accuracy and acceptability of the novel 3D printed individualized guiding templates based on cutaneous fiducial markers in minimally invasive screw placement for pelvic fractures. Methods The printed template was tested on five high-fidelity biomimetic phantom models of the bony pelvis and its surrounding soft tissues as well as on two fresh frozen cadavers. Four cutaneous fiducial markers were transfixed on each phantom model prior to performing CT scans to reconstruct their 3D models. Personalized templates for guiding screw insertion were designed based on the positions of the fiducial markers and virtually planned target screw channels after scanning, followed by 3D printing of the guide. Phase 1 consisted of five expert surgeons inserting one anterograde supra-pubic screw and one sacroiliac screw percutaneously into each phantom model using the 3D-printed guide. The deviation of screw positions between the pre-operative planned and post-operative actual ones was measured after registering their 3D modelling. A Likert scale questionnaire was completed by the expert surgeons to assess their satisfaction and acceptability with the guiding template. Phase 2 consisted of repeating the same procedures on the fresh frozen cadavers in order to demonstrate face, content and concurrent validity. Results In Phase 1, all ten screws were successfully implanted with the assistance of the guiding template. Postoperative CT scans confirmed that all screws were safely positioned within the bony pelvic channels without breaching the far cortex. The mean longitudinal deviation at the bony entry point and screw tip between the pre-operative planned and post-operative actual screw paths were 2.83 ± 0.60 mm and 3.12 ± 0.81 mm respectively, with a mean angular deviation of 1.25 ± 0.41°. Results from the Likert questionnaire indicated a high level of satisfaction for using the guiding template among surgeons. In Phase 2, results were similar to those in Phase 1. Conclusions The 3D-printed guiding template based on cutaneous fiducial markers shows potential for assisting in the accurate insertion of percutaneous screws in the pelvis.https://doi.org/10.1186/s12893-024-02402-6Pelvic fractureBone screwsFiducial markers3D PrintingPersonalized guiding template |
| spellingShingle | Xingguang Tao Fei Lyu Kapil Sugand Kaihua Zhou Huixiang Wang Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study BMC Surgery Pelvic fracture Bone screws Fiducial markers 3D Printing Personalized guiding template |
| title | Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study |
| title_full | Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study |
| title_fullStr | Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study |
| title_full_unstemmed | Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study |
| title_short | Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study |
| title_sort | does a novel 3d printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws a preliminary phantom and cadaver study |
| topic | Pelvic fracture Bone screws Fiducial markers 3D Printing Personalized guiding template |
| url | https://doi.org/10.1186/s12893-024-02402-6 |
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