Accuracy of placement of pedicle screws in the thoracolumbar spine of dogs with spinal deformities with three‐dimensionally printed patient‐specific drill guides

Authors: 
Elford JH, Oxley B, Behr S.
Vet Surg. 2019 Oct 16. doi: 10.1111/vsu.13333.

OBJECTIVE: To determine the accuracy of pedicle screw placement in the thoracic spine of dogs with spinal deformities with three-dimensionally (3D) printed patient-specific drill guides.

STUDY DESIGN: Retrospective study.

SAMPLE POPULATION: Six dogs in which sixty pedicle screws were placed in the thoracolumbar spine.

METHODS: Medical records were searched between June 2017 and June 2018 for dogs with clinical signs associated with a thoracolumbar vertebral malformation. Inclusion criteria included MRI and computed tomography (CT) data that were used to create 3D printed patient-specific drill guides. All dogs were stabilized dorsally with guided bicortical pedicle screws and polymethylmethacrylate. Accuracy of screw placement was assessed by immediately postoperative CT according to a modified Zdichavsky classification.

RESULTS: Five pugs and one French bulldog met the inclusion criteria. Sixty bicortical pedicle screws were placed; 96.7% were graded as I (optimal placement), and 3.3% were classified as IIa (partial penetration of the medial pedicle wall) according to a modified Zdichavsky classification.

CONCLUSION: Three-dimensionally printed patient-specific drill guides allowed safe and accurate placement of pedicle screws in the thoracolumbar spine in dogs with vertebral malformation.

CLINICAL SIGNIFICANCE: Three-dimensionally printed patient-specific drill guides are a safe and effective method of placing pedicle screws in dogs with thoracolumbar vertebral malformations.

Small animal: