Application study of three-dimensional printed navigation template between traditional and novel cortical bone trajectory on osteoporosis lumbar spine.

To investigate the safety, accuracy and indications of traditional and novel cortical bone screws placement for osteoporosis lumbar spine, 4 lumbar vertebra specimens (2 males and 2 females) were used for this study. After the computed tomography scanning data of the above anatomical specimens were three-dimensional (3D) reconstructed, one side of each anatomical specimen was randomly chosen to place traditional cortical bone screws, and the other side received novel technical placement. The safety screw trajectory was designed, and a 3D navigation template complementary to the surface anatomical structure of lumbar isthmus lateral margin-vertebral plate-spinous process part was established. The designed supporting navigation template was substantialized, and the navigation template replicated different cortical bone screw trajectory at different sides of the same one lumbar vertebra. Forty cortical bone screws were firstly placed in 3D printed vertebra and then 40 were placed in real anatomical specimens. In 3D printed specimens, the success rates of screw placement with navigation template using traditional and novel techniques were both 100%. While in anatomical specimens, the success rate of screw placement using traditional and novel navigation template was 97.5% (one out of 40 went wrong). Therefore, it is safe, accurate and reliable to place traditional and novel cortical bone screws on osteoporosis lumbar spine using 3D printed navigation template. Traditional and novel screw placement methods should be flexibly applied or combined according to specific sequence and form of vertebra.