Three-Dimensional Planning and Use of Individualized Osteotomy-Guiding Templates for Surgical Correction of Kyphoscoliosis: A Technical Case Report.

OBJECTIVE: We have described the use of 3-dimensional (3D) virtual planning and 3D printed patient-specific osteotomy templates in the surgical correction of a complex spinal deformity. Pedicle subtraction osteotomies (PSOs) for the correction of severe spinal deformities are technically demanding procedures with a risk of major complications. In particular, operations of the severely deformed spine call for new, more precise, methods of surgical planning. The new 3D technology could result in new possibilities for the surgical planning of spinal deformities.

METHODS: We present the case of severe congenital kyphoscoliosis in a young girl with skeletal dysplasia. A closing wedge-extended PSO was 3D virtual planned using medical computer design software. After the optimal 3D-wedge procedure was planned, individualized osteotomy-guiding templates were designed for translation of the planned PSO to the surgical procedure. During surgery, the PSO was performed using the osteotomy templates. Successful correction of the kyphoscoliosis was realized.

RESULTS: The kyphosis was successfully reduced using a wedge-shaped extended PSO using preoperative 3D virtual planning, assisted by 3D-printed individualized osteotomy-guiding templates.

CONCLUSIONS: In addition to direct translation of the planned PSO for surgery, the 3D planning also facilitated a detailed preoperative evaluation, greater insight into the case-specific anatomy, and accurate planning of the required correction.