Subscribe to RSS
Accuracy of Placement of Pedicle Screws in the Lumbosacral Region of Dogs Using 3D-Printed Patient-Specific Drill Guides
Objective The aim of this study was to report the accuracy of pedicle screw placement using three-dimensional (3D)-printed, patient-specific drill guides in the lumbosacral region of dogs.
Study Design This was a retrospective study. Thirty-two pedicle screws were placed in five dogs. Medical records were reviewed between November 2015 and November 2018 for dogs showing clinical signs associated with cauda equina syndrome. Inclusion criteria included preoperative magnetic resonance imaging, pre- and postoperative computed tomography (CT) and dorsal stabilization, with pedicle screws placed using 3D-printed, patient-specific drill guides and polymethylmethacrylate. Screw placement was evaluated for medial or lateral breaching on postoperative CT.
Results Five dogs met the inclusion criteria. Four had degenerative lumbosacral stenosis and one had discospondylitis. All dogs had failed medical management prior to surgery. Of 32 bicortical pedicle screws placed, 30 were fully contained inside the pedicle and 2 were partially breaching the vertebral canal (less than one-third of the screw diameter). Postoperative CT revealed good alignment of L7-S1 in all planes.
Conclusion This technique enabled an accurate and safe placement of pedicle screws in the lumbosacral region of dogs with lumbosacral disease. Three-dimensional, printed patient-specific drill guides are a safe and effective method of placing pedicle screws in dogs with lumbosacral disease.
C.T. contributed to conception of study, study design, acquisition of data and data analysis and interpretation. S.C., B.O and S.B. contributed to conception of study, study design, and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.
Received: 06 January 2020
Accepted: 30 July 2020
Article published online:
16 October 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Platt SR, da Costa RC. Cervical spine. In: Elsevier S. ed. Veterinary Surgery Small Animals. 1st ed.. St. Louis, MI: Elsevier, Saunders; 2012: 418-424
- 2 Beer P, Park BH, Steffen F, Smolders DLA, Pozzi A, Knell SC. Influence of a customized three-dimensionally printed drill guide on the accuracy of pedicle screw placement in lumbosacral vertebrae: an ex vivo study. Vet Surg 2020; 49 (05) 977-988
- 3 Golini L, Kircher PR, Lewis FI, Steffen F. Transarticular fixation with cortical screws combined with dorsal laminectomy and partial discectomy as surgical treatment of degenerative lumbosacral stenosis in 17 dogs: clinical and computed tomography follow-up. Vet Surg 2014; 43 (04) 405-413
- 4 Meij BP, Bergknut N. Degenerative lumbosacral stenosis in dogs. Vet Clin North Am Small Anim Pract 2010; 40 (05) 983-1009
- 5 Dewey CW, da Costa RC. Practical Guide to Canine and Feline Neurology. Iowa: John Wiley and Sons; 2016
- 6 Willems N, Kersten RFMR, van Gaalen SM. et al. Temporary segmental distraction in a dog with degenerative lumbosacral stenosis. Vet Comp Orthop Traumatol 2018; 31 (04) 298-303
- 7 De Decker S, Wawrzenski LA, Volk HA. Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004-2012). J Am Vet Med Assoc 2014; 245 (04) 408-413 1
- 8 Renwick AIC, Dennis R, Gemmill TJ. Treatment of lumbosacral discospondylitis by surgical stabilisation and application of a gentamicin-impregnated collagen sponge. Vet Comp Orthop Traumatol 2010; 23 (04) 266-272
- 9 Royaux E, Guilherme S. Diagnosis and treatment of lumbosacral vertebral instability caused by discospondylitis in a dog. Vlaams Diergeneeskd Tijdschr 2018; 87 (04) 201-206
- 10 Harris JM, Chen AV, Tucker RL, Mattoon JS. Clinical features and magnetic resonance imaging characteristics of diskospondylitis in dogs: 23 cases (1997-2010). J Am Vet Med Assoc 2013; 242 (03) 359-365
- 11 Auger J, Dupuis J, Quesnel A, Beauregard G. Surgical treatment of lumbosacral instability caused by discospondylitis in four dogs. Vet Surg 2000; 29 (01) 70-80
- 12 Jeffery ND, Barker A, Harcourt-Brown T. What progress has been made in the understanding and treatment of degenerative lumbosacral stenosis in dogs during the past 30 years?. Vet J 2014; 201 (01) 9-14
- 13 Shores A, Brissone BA. Lumbosacral decompression and foraminotomy in current techniques in canine and feline neurosurgery. 1st ed. Hoboken, NJ: Wiley-Blackwell; 2017: 673-674
- 14 Zindl C, Litsky AS, Fitzpatrick N, Allen MJ. Kinematic behavior of a novel pedicle screw-rod fixation system for the canine lumbosacral joint. Vet Surg 2018; 47 (01) 114-124
- 15 Müller F, Schenk HC, Forterre F. Short-term and long-term effects of a minimally invasive transilial vertebral blocking procedure on the lumbosacral morphometry in dogs measured by computed tomography. Vet Surg 2017; 46 (03) 354-366
- 16 Hankin EJ, Jerram RM, Walker AM, King MD, Warman CGA. Transarticular facet screw stabilization and dorsal laminectomy in 26 dogs with degenerative lumbosacral stenosis with instability. Vet Surg 2012; 41 (05) 611-619
- 17 Cong Y, Bao N, Zhao J, Mao G. Comparing accuracy of cervical pedicle screw placement between a guidance system and manual manipulation: a cadaver study. Med Sci Monit 2015; 21: 2672-2677
- 18 Fujioka T, Nakata K, Nishida H. et al. A novel patient-specific drill guide template for stabilization of thoracolumbar vertebrae of dogs: cadaveric study and clinical cases. Vet Surg 2018; (October): 1-7
- 19 Kamishina H, Sugawara T, Nakata K. et al. Clinical application of 3D printing technology to the surgical treatment of atlantoaxial subluxation in small breed dogs. PLoS One 2019; 14 (05) e0216445
- 20 Dewey CW, Davies E, Bouma JL. Kyphosis and kyphoscoliosis associated with congenital malformations of the thoracic vertebral bodies in dogs. Vet Clin North Am Small Anim Pract 2016; 46 (02) 295-306
- 21 Wang YT, Yang XJ, Yan B, Zeng TH, Qiu YY, Chen SJ. Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders. Chin J Traumatol 2016; 19 (01) 31-34
- 22 Hamilton-Bennett SE, Oxley B, Behr S. Accuracy of a patient-specific 3D printed drill guide for placement of cervical transpedicular screws. Vet Surg 2018; 47 (02) 236-242
- 23 Elford JH, Oxley B, Behr S. Accuracy of placement of pedicle screws in the thoracolumbar spine of dogs with spinal deformities with three-dimensionally printed patient-specific drill guides. Vet Surg 2019; (March): 1-7
- 24 Chen H, Wu D, Yang H, Guo K. Clinical use of 3D printing guide plate in posterior lumbar pedicle screw fixation. Med Sci Monit 2015; 21: 3948-3954
- 25 Wilcox B, Mobbs RJ, Wu A-M, Phan K. Systematic review of 3D printing in spinal surgery: the current state of play. J Spine Surg 2017; 3 (03) 433-443