Research

Although 3D CAT scan reconstruction can help in the planning of complex reconstructive surgery for spinal deformities, the exact detailed, 3D nature of the deformity is often not appreciated. Novel, plastic spine models, made using a CAD/CAM machine and 1mm thin cut CAT scan, were utilized in surgical planning and inter-operatively in four recent complex reconstructive surgery cases.

Two cases involved patients with severe kyphosis and scoliosis and pseudoarthroses – (a post-laminectomy kyphosis, unknown dwarfism). The model allowed for optimum choice of surgical approach to the deformity.

Another case involved a congenital scoliosis fused posteriorly only at an early age with subsequent deterioration due to continued anterior growth (crankshaft effect). The model allowed for precise planning of the magnitude and position of the posterior corrective wedge excision to provide appropriate correction.

The final case was a child with metatrophic dysplasia who had undergone a prior anterior/posterior fusion and was experiencing cord compression. Splitting the physical model down the spinal canal showed the compressive pathology, and allowed for the correct surgical decision of performing a posterolateral approach rather than an anterior decompression.

Physical spine models are a valuable tool in the pre-operative planning and surgical treatment of complex deformities allowing more accurate 3D visualization than 3D CAT scan reconstruction.