Comparison of three-dimensional printing-assisted pedicle screw placement and traditional surgery for lumbar spondylolisthesis: a meta-analysis

doi:10.3969/j.issn.2095-4344.2829

Abstract

Abstract:

BACKGROUND: With the development of three-dimensional (3D) printing technology, it has been widely used in spinal surgery. However, whether 3D printing-assisted surgery for lumbar spondylolisthesis has an advantage over traditional surgery is still controversial.

OBJECTIVE: To compare the clinical efficacy and safety of 3D printing-assisted versus conventional surgery for the treatment of lumbar spondylolisthesis using system evaluation.

METHODS: Randomized controlled trials about 3D printing technology for lumbar spondylolisthesis in CNKI, Wanfang database, CBM, VIP, PubMed, Cochrane Library, Embase, and Web of Science were searched via computer from inception to November 16, 2019. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation was performed. Then, the available data were extracted and analyzed with the Stata 11.0 software.

RESULTS AND CONCLUSION: (1) Six randomized controlled trials including 394 cases were included. Among them, 201 cases were assigned to the 3D printing-assisted group and 193 cases to the conventional group. (2) Meta-analysis results showed that the 3D printing-assisted group proved significantly superior to the conventional group regrading the operation time [WMD=-38.17, 95%CI(-43.93, -32.41), P=0.00], intraoperative blood loss [WMD=-61.61, 95%CI(-69.19, -54.03), P=0.00], the frequency of fluoroscopy [WMD=-4.89, 95%CI(-6.38, -3.41), P=0.00] and the screw placement accuracy [OR=3.89, 95%CI(2.43, 6.25), P=0.00]. (3) However, in terms of the postoperative visual analogue scale scores [WMD=-0.47, 95%CI(-1.21, 0.27), P=0.215], Oswestry disability index [WMD=-1.41, 95%CI(-2.87, 0.05), P=0.058], Japanese Orthopaedic Association scores [WMD=1.02, 95%CI(-0.68, 2.72), P=0.240] and the rate of complications [OR=0.37, 95%CI(0.12, 1.11), P=0.075], no statistically significant differences were found between the two groups. (4) In conclusion, the application of 3D printing technology in the surgical treatment of lumbar spondylolisthesis has the advantage of shortening the operation time, reducing intraoperative blood loss and frequency of fluoroscopy and improving the accuracy of the screw placement.

Key words: bone, lumbar spondylolisthesis, three-dimension, traditional surgery, screw placement, complications, fluoroscopy, randomized controlled trial, meta-analysis

CLC Number:

Zhou Junde, Fan Zhirong, Su Haitao, Peng Jiajie, Zhou Lin, Hong Weiwu, Huang Huida. Comparison of three-dimensional printing-assisted pedicle screw placement and traditional surgery for lumbar spondylolisthesis: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(30): 4898-4904.

Figures/Tables 11

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