Vet Comp Orthop Traumatol
DOI: 10.1055/a-2590-9143
Original Research

Comparative Analysis of 3D-Printed Drill Guides and Minimally Invasive Osteosynthesis in Feline Sacroiliac Luxation: A Cadaveric Study

1   Department of Surgery, Tierklinik Düsseldorf, Düsseldorf, Germany
,
Fee Marie Fohrmann
1   Department of Surgery, Tierklinik Düsseldorf, Düsseldorf, Germany
,
Cosmin Muresan
2   Department of Surgery, Anaesthesia and Intensive Care, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
,
Alexandru Gabriel Neagu
3   Department of Diagnostic Imaging, Faculty of Veterinary Science Bucharest, University of of Agricultural Sciences and Veterinary Medicine Bucharest, Bucharest, Romania
,
Niculae Tudor
3   Department of Diagnostic Imaging, Faculty of Veterinary Science Bucharest, University of of Agricultural Sciences and Veterinary Medicine Bucharest, Bucharest, Romania
,
Maximiljan W. Krauss
1   Department of Surgery, Tierklinik Düsseldorf, Düsseldorf, Germany
› Author Affiliations
Funding The authors disclose that Arthrex provided funding in the form of the implants used for the study (Study ID: IIRR-01601).

Abstract

Objectives

This study was conducted to evaluate the efficacy of a 3D-printed drill guide technique (3D-DGT) in facilitating sacroiliac screw placement in feline cadavers with sacroiliac luxation (SIL), compared with minimally invasive osteosynthesis (MIO). Additionally, the accuracy and precision of implant placement in relation to preoperative planning were evaluated.

Study Design

Bilateral SIL was created in 14 feline cadavers, followed by preoperative CT scans. For both techniques, preoperative planning was performed, and 2.4-mm screws were implanted. Postoperative CT scans were then performed to evaluate screw placement accuracy, entry point translation (EPT), and the maximum angular screw deviation (MASD) in dorsal and transverse planes.

Results

In the lateral plane, the median (IQR) EPT (in mm) with MIO significantly differed from that with 3D-DGT on the y-axis (dorsoventral direction) from the planned entry location (Mann-Whitney U test, U = 42.5, Z = −2.55, p = 0.009). However, no significant differences were noted on the x-axis (craniocaudal direction) from the planned entry location (Mann–Whitney U test, U = 60, Z = −1.76, p = 0.08). Median (IQR) MASD did not differ significantly between MIO and 3D-DGT in either dorsal or transverse planes (Mann–Whitney U test, U = 77, Z = −0.98, p = 0.34; U = 64, Z = −1.57, p = 0.12, respectively).

Conclusion

The use of 3D-DGT lead to fewer suboptimal placements compared with MIO (7.14% versus 42.85%), though the difference was not statistically significant.

Ethical Approval Statement

Ethical approval was granted by the Bioethics Committee of the Faculty of Veterinary Medicine Bucharest, Approval Issue no. 23 17.05.2022.


Authors' Contribution

All authors contributed to the conception, study design, acquisition of data, data analysis and interpretation. All authors drafted, revised, and approved the submitted manuscript and are publicly responsible for the relevant content.




Publication History

Received: 28 August 2024

Accepted: 17 April 2025

Article published online:
30 April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 
  • References

  • 1 Bookbinder PF, Flanders JA. Characteristics of pelvic fracture in the cat: a 10-year retrospective study. Vet Comp Orthop Traumatol 1992; 5(3): 122-127
  • 2 Bennett D. Orthopaedic disease affecting the pelvic region of the cat. J Small Anim Pract 1975; 16 (11) 723-738
  • 3 Anderson A, Coughlan AR. Sacral fractures in dogs and cats: a classification scheme and review of 51 cases. J Small Anim Pract 1997; 38 (09) 404-409
  • 4 Bird FG, de Vicente F. Conservative management of sacroiliac luxation fracture in cats: medium- to long-term functional outcome. J Feline Med Surg 2020; 22 (06) 575-581
  • 5 Averill SM, Johnson AL, Schaeffer DJ. Risk factors associated with development of pelvic canal stenosis secondary to sacroiliac separation: 84 cases (1985-1995). J Am Vet Med Assoc 1997; 211 (01) 75-78
  • 6 Burger M, Forterre F, Brunnberg L. Surgical anatomy of the feline sacroiliac joint for lag screw fixation of sacroiliac fracture-luxation. Vet Comp Orthop Traumatol 2004; 17(3): 146–151
  • 7 Shales C, Moores A, Kulendra E, White C, Toscano M, Langley-Hobbs S. Stabilization of sacroiliac luxation in 40 cats using screws inserted in lag fashion. Vet Surg 2010; 39 (06) 696-700
  • 8 Silveira F, Quinn RJ, Adrian AM, Owen MR, Bush MA. Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats. Vet Comp Orthop Traumatol 2017; 30 (01) 69-74
  • 9 Kaderly RE. Stabilization of bilateral sacroiliac fracture-luxations in small animals with a single transsacral screw. Vet Surg 1991; 20 (02) 91-96
  • 10 Yap FW, Dunn AL, Farrell M, Calvo I. Trans-iliac pin/bolt/screw internal fixation for sacroiliac luxation or separation in cats: six cases. J Feline Med Surg 2014; 16 (04) 354-362
  • 11 Raffan PJ, Joly CL, Timm PG, Miles JE. A tension band technique for stabilisation of sacroiliac separations in cats. J Small Anim Pract 2002; 43 (06) 255-260
  • 12 Parslow A, Simpson DJ. Bilateral sacroiliac luxation fixation using a single transiliosacral pin: surgical technique and clinical outcomes in eight cats. J Small Anim Pract 2017; 58 (06) 330-336
  • 13 Froidefond B, Moinard M, Caron A. Outcomes for 15 cats with bilateral sacroiliac luxation treated with transiliosacral toggle suture repair. Vet Surg 2023; 52 (07) 983-993
  • 14 Wills DJ, Neville-Towle J, Podadera J, Johnson KA. Computed tomographic evaluation of the accuracy of minimally invasive sacroiliac screw fixation in cats. Vet Comp Orthop Traumatol 2022; 35 (02) 119-127
  • 15 Kleiner L, Wolf N, Precht C, Haenssgen K, Forterre F, Düver P. Feline sacroiliac luxation: comparison of fluoroscopy-controlled freehand vs. computer-navigated drilling in the sacrum-a cadaveric study. Front Vet Sci 2025; 11: 1510253
  • 16 Burger M, Forterre F, Waibl H, Brunnberg L. Sacroiliac luxation in the cat. Part 2: cases and results. Kleintierpraxis 2005; 50 (05) 287-297
  • 17 Forterre F, Tomek A, Rytz U, Brunnberg L, Jaggy A, Spreng D. Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006). Vet Surg 2007; 36 (05) 464-471
  • 18 Shales CJ, White L, Langley-Hobbs SJ. Sacroiliac luxation in the cat: defining a safe corridor in the dorsoventral plane for screw insertion in lag fashion. Vet Surg 2009; 38 (03) 343-348
  • 19 Déjardin LM, Fauron AH, Guiot LP, Guillou RP. Minimally invasive lag screw fixation of sacroiliac luxation/fracture using a dedicated novel instrument system: apparatus and technique description. Vet Surg 2018; 47 (01) 93-103
  • 20 Déjardin LM, Marturello DM, Guiot LP, Guillou RP, DeCamp CE. Comparison of open reduction versus minimally invasive surgical approaches on screw position in canine sacroiliac lag-screw fixation. Vet Comp Orthop Traumatol 2016; 29 (04) 290-297
  • 21 Tomlinson J. Minimally invasive repair of sacroiliac luxation. Vet Clin North Am Small Anim Pract 2020; 50 (01) 231-239
  • 22 Rollins A, Balfour R, Szabo D, Chesvick CM. Evaluation of fluoroscopic-guided closed reduction versus open reduction of sacroiliac fracture-luxations stabilized with a lag screw. Vet Comp Orthop Traumatol 2019; 32 (06) 467-474
  • 23 McCarthy DA, Granger LA, Aulakh KS, Gines JA. Accuracy of a drilling with a custom 3D printed guide or free-hand technique in canine experimental sacroiliac luxations. Vet Surg 2022; 51 (01) 182-190
  • 24 Fischer A, Binder E, Reif U, Biel M, Bokemeyer J, Kramer M. Closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm cannulated screws—a cadaveric study. Vet Comp Orthop Traumatol 2012; 25 (01) 22-27
  • 25 Tomlinson J. Minimally invasive repair of sacroiliac luxation in small animals. Vet Clin North Am Small Anim Pract 2012; 42 (05) 1069-1077 , viii viii
  • 26 Gras F, Marintschev I, Wilharm A, Klos K, Mückley T, Hofmann GO. 2D-fluoroscopic navigated percutaneous screw fixation of pelvic ring injuries—a case series. BMC Musculoskelet Disord 2010; 11: 153
  • 27 Han CK, Kang J, Lee H, Kim N, Heo S. Evaluation of a screw insertion landmark for a minimally invasive repair technique in induced bilateral sacroiliac luxation in feline cadavers. J Feline Med Surg 2022; 24 (02) 152-159
  • 28 Ahn SY, Jeong SW. Evaluation of minimally invasive surgical reduction of sacroiliac luxation in toy breed dogs: a cadaver study. J Vet Sci 2022; 23 (02) e38
  • 29 de Jong L, Proot JLJ, Pillin LJP, Janssens LAA. Minimally invasive placement of cannulated headless compression screws for reduction of sacroiliac luxation in 14 cats. Vet Comp Orthop Traumatol 2024; (e-pub ahead of print)
  • 30 Van Assche N, Quirynen M. Tolerance within a surgical guide. Clin Oral Implants Res 2010; 21 (04) 455-458