94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1520481
This article is part of the Research Topic Minimally Invasive Treatments for Lumbar Spine Disorders View all 3 articles
Comparative Study of Individualized 3D-Printing Navigation Technology and Free-Hand Isthmus Method in Lumbar CBT Screw Implantation
Provisionally accepted- 1 Affiliated Nanhua Hospital, University of South China, Hengyang, China
- 2 Nanhua Hospital, University of South China, Health School of Nuclear Industry, Hengyang, China
Objectives: Traditional cortical bone trajectory (CBT) screws in the lumbar spine offer greater holding strength and are well-suited for patients with osteoporosis. However, the screw implantation procedure is challenging and associated with significant risk. This study aimed to assess whether individualized 3D-printing navigation technology provides higher accuracy and better clinical outcomes compared to the free-hand isthmus method for lumbar CBT screw implantation.Methods: From September 2020 to August 2023, a total of 41 patients who underwent CBT screw surgery were retrospectively collected. Among them, 23 patients underwent the free-hand isthmus method (Group A), while 18 patients underwent the individualized 3D-printing navigation technique (Group B). All imaging and clinical data for these patients were collected in a blinded manner.Results: During the surgery, 185 CBT screws were implanted into the lumbar spines of 41 patients-78 in Group A and 107 in Group B. After the surgery, the majority of implanted screws (86.5%) were classified as grade 0, indicating satisfactory implantation. Compared to Group A, Group B had fewer screws classified as grade 1 or grade 2 (p = 0.045), indicating higher accuracy in screw implantation. Additionally, Group B also had a shorter operation duration (p = 0.02), fewer fluoroscopy exposures (p < 0.01), and less blood loss (p = 0.03). In addition, compared to Group A, individuals in Group B showed significant improvement in back pain symptoms at both 3 and 6 months (p = 0.01 and <0.01), as well as in physical activity at 3 months (p = 0.02) postoperatively. No significant difference in postoperative complications was observed between the two groups.Conclusion： Compared to the free-hand isthmus method, lumbar CBT screw implantation with individualized 3D-printing navigation technology shows higher accuracy, shorter operative time, reduced intraoperative fluoroscopy and blood loss, and better clinical outcomes at three months postsurgery.
Keywords: Cortical Bone Trajectory Screw, 3D-printing navigation molds, Free-hand isthmus method, Lumbar internal fixation surgery, Retrospective study
Received: 31 Oct 2024; Accepted: 14 Mar 2025.
Copyright: © 2025 Hu, Ou, Lu and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Ou, Affiliated Nanhua Hospital, University of South China, Hengyang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.