Three-Dimensional Printing Applications in Pediatric Spinal Surgery: A Systematic Review.

Study Design: Systematic Review.
Objective: 3DP technology use has become increasingly more common in the field of medicine and is notable for its growing utility in spine surgery applications. Many studies have evaluated the use of pedicle screw placement guides and spine models in adult spine patients, but there is little evidence assessing its efficacy in pediatric spine patient populations. This systematic review identifies and evaluates the current applications and surgical outcomes of 3-Dimensional Printing (3DP) technology in pediatric spinal surgery.
Methods: A search of publications was conducted using literature databases and relevant keywords in concordance with PRISMA guidelines. Inclusion criteria consisted of original studies, and studies focusing on the use of 3DP technology in pediatric spinal surgery. Studies with a focus on adult populations, non-deformity surgery, animal subjects, systematic or literature reviews, editorials, or non-English studies were excluded from further analysis.
Results: After application of inclusion/exclusion criteria, we identified 25 studies with 3DP applications in pediatric spinal surgery. Overall, the studies found significantly improved screw placement accuracy using 3DP pedicle screw placement guides but did not identify significant differences in operative time or blood loss. All studies that utilized 3D spine models in preoperative planning found it helpful and noted an increased screw placement accuracy rate of 89.9%.
Conclusions: 3DP applications and techniques are currently used in pre-operative planning using pedicle screw drill guides and spine models to improve patient outcomes in pediatric spinal deformity patients.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Prerana Katiyar, Venkat Boddapati, Josephine Coury, and Benjamine Roye have no financial interests. Michael Vitale receives royalties from Zimmer Biomet, is a consultant for NuVasive and Stryker, is on the board of directors for Children’s Spine Foundation and Pediatric Orthopedic Society of North America, and has current grant/research support from Scoliosis Research Society, Children’s Spine Foundation and Pediatric Orthopedic Society of North America, and the Orthopedic Scientific Research Foundation. Lawrence Lenke has received royalties from Medtronic, consulting fees from Medtronic and Acuity Surgical, and is a reviewer for the following journals: Spine, The Spine Journal, European Spine Journal, AO Spine Deformity Knowledge Forum, JBJS, GSJ, ISSG, Spine Deformity.