Orthopaedics

Spine surgery has become safer and more effective especially during the last couple of decades due to the advancements in the field. The latest spinal implants, modern techniques and the extensive training of specialist spine surgeons have reduced such incidences to a rarity and made spine surgery lot more favorable when rightly indicated. Technological advancements have also contributed to making the surgery more safe and accurate. The evolution of robotics and navigation in spine surgery has helped to make spinal instrumentation (insertion of pedicle screws in the vertebra for stabilization and fusion procedures) to achieve close to 99% accuracy compared to a freehand or xray guided techniques. But, the issue with these advancements is the high investments on the machines leading to higher cost of surgery which makes it not affordable for most middle class citizens. Radiation exposure to the surgeons and staff is another disadvantage.

A latest advancement in this field is using additive manufacturing or 3d printing technology. The technology allows patient specific surgical guides to insert screws and helps achieve highest safety and accuracy levels. The guides are customized to the patient based on their CT scan and most patients would be able to afford them. For the first time in Kerala, 3d printed patient specific surgical guides were used for complex spine surgery at Aster MIMS Calicut. The guides were printed after a detailed discussion by the surgeon with the engineers in Mumbai and were shipped prior to the case.

This particular patient had an infection involving the sacrum and needed lumbar to spinopelvic fixation. Commonly these S2AI screws are done by freehand technique and involves risk of neurovascular injuries. Use of 3D printed guides in such complex spine surgery was done as a niche procedure which saves cost, prevents complications and improve outcomes. 3d printing technology provides a state of the art advancement in spine surgery at an affordable cost to the patients and is especially useful in complex spine surgery, revision surgery and deformity corrections like scoliosis surgeries