Section 4 Surgical Planning

**65**

**Chapter 5**

Surgery

**Abstract**

operability.

**1. Introduction**

Surgical Planning and Additive

Model: A Case Study of a Spine

*Levent Aydin, Ozgur Cakir, Riza Dilek and Mucahit Ege*

3D scanning technologies have promising solutions for medical needs such as anatomical models, biocompatible implants, and orthotic/prosthetic models. Although virtual presurgical planning offers more precise results, it may not be applied in every hospital because of the high costs. The aim of this study is to assess the accuracy of the suggested low-cost and effective surgical planning method by means of additive manufacturing to increase success rate of each surgery. In this study, a full spine model of a scoliosis patient was acquired and reconstructed in MIMICS software using different filters and parameters. Therefore, a comparison in terms of geometrical errors among each model was performed based on a reference model. Subsequently, patient-specific full spine model was manufactured using a three-dimensional printing method (fused deposition modeling) and utilized before the surgery. 3D surgical model reconstruction parameters such as wrap tool, binomial blur, and curvature flow filters produced high geometrical errors, while mean filter produced the lowest geometrical error. Furthermore, similarity results of the curvature flow and discrete Gaussian filters were close to mean filter. Smooth tool and mean filter produced almost the same volume of the reference model. Consequently, an ideal protocol for surgical planning of a spine surgery is defined with measurable accuracy. Thus, success rate of a spine surgery may be increased especially for the severe cases owing to the more accurate preoperative review:

**Keywords:** additive manufacturing, image guided surgery, orthopedic surgery,

Scoliosis is a three-dimensional (3D) deformity in the natural shape of spine that requires surgery in serious cases [1]. A lateral deviation of the spine greater than 10 degrees is accepted as scoliosis and an abnormal sideways curvature is observed from the frontal plane of a patient, while a healthy spine should look like straight [2, 3]. Although hereditary factors play a role in the etiology, most of the cases (80% of the patients) with unknown cause are called idiopathic scoliosis and classified into three main groups based on the age, namely, (i) infantile (up to 3 years

surgical planning, accuracy assessment, scoliosis

Manufacturing of an Anatomical

#### **Chapter 5**
