A novel technique for precise rod contouring using template rod in minimally invasive spine fixation: a case report
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261237Keywords:
Rod contouring, Minimally invasive spine fixation, Rod templating techniqueAbstract
To present an innovative rod templating technique that improves precision in rod contouring and insertion during minimally invasive spine fixation, particularly in cases involving osteoporosis and limited surgical exposure. After insertion of pedicle screws in a 72-year-old osteoporotic patient undergoing delta fixation for high-grade listhesis, an aluminium template rod was passed through the screw tulips and fixed with set screws to capture the spatial configuration of the construct. The contoured template was then used to shape the final titanium rod, which was inserted and secured to achieve in-situ fixation. The templating technique facilitated precise rod contouring, smooth rod passage, and secure fixation without screw backout. The patient experienced significant pain relief and was able to ambulate early. Follow-up at six months showed stable implant positioning with no evidence of screw loosening or pullout. This template-based rod contouring method enhances biomechanical alignment, reduces operative time, and minimises the risk of screw pullout in minimally invasive spine fixation, offering improved surgical efficiency and construct stability in challenging osteoporotic cases.
References
Erickson MA, Oliver T, Baldini T, Bach J. Biomechanical Assessment of Conventional Unit Rod Fixation Versus a Unit Rod Pedicle Screw Construct. Spine. 2004;29(12):1314-9.
Walker CT, Xu DS, Godzik J, Turner JD, Uribe JS, Smith WD. Minimally invasive surgery for thoracolumbar spinal trauma. Ann Transl Med. 2018;6(6):102.
Jaikumar S, Kim DH, Kam AC. History of Minimally Invasive Spine Surgery. Neurosurgery. 2002;51(2):S2-1-14.
Grossbach AJ, Dahdaleh NS, Abel TJ, Woods GD, Dlouhy BJ, Hitchon PW. Flexion-distraction injuries of the thoracolumbar spine: open fusion versus percutaneous pedicle screw fixation. Neurosurg Focus. 2013;35(2):E2.
Alander DH, Cui S. Percutaneous Pedicle Screw Stabilization: Surgical Technique, Fracture Reduction, and Review of Current Spine Trauma Applications. J Am Acad Orthop Surg. 2018;26(7):231-40.
Tajsic T, Patel K, Farmer R, Mannion RJ, Trivedi RA. Spinal navigation for minimally invasive thoracic and lumbosacral spine fixation: implications for radiation exposure, operative time, and accuracy of pedicle screw placement. Eur Spine J. 2018;27(8):1918-24.
Wang H, Zhou Y, Li C, Liu J, Xiang L. Comparison of Open Versus Percutaneous Pedicle Screw Fixation Using the Sextant System in the Treatment of Traumatic Thoracolumbar Fractures. Clin Spine Surg. 2017;30(3):E239-46.
Ishii K, Funao H, Isogai N, Saito T, Arizono T, Hoshino M, et al. The History and Development of the Percutaneous Pedicle Screw (PPS) System. Medicina. 2022;58(8):1064.
Li R, Davoodi A, Timmermans M, Van Assche K, Taylan O, Scheys L, et al. Ultrasound-Based Robot-Assisted Drilling for Minimally Invasive Pedicle Screw Placement. IEEE Trans Med Robot Bionics. 2024;6(3):818-28.
Piovesan A, Berti F, Villa T, Pennati G, La Barbera L. Computational and Experimental Fatigue Analysis of Contoured Spinal Rods. J Biomech Eng. 2019;141(4):041007.
Baroudi M, Daher M, Maheshwari K, Singh M, Nassar JE, McDonald CL, et al. Surgical Management of Adult Spinal Deformity Patients with Osteoporosis. J Clin Med. 2024;13(23):7173.
Lehman RA, Kang DG, Wagner SC. Management of Osteoporosis in Spine Surgery. J Am Acad Orthop Surg. 2015;23(4):253-63.
Charles YP, Walter A, Schuller S, Aldakheel D, Steib JP. Thoracolumbar fracture reduction by percutaneous in situ contouring. Eur Spine J. 2012;21(11):2214-21.
Sardi JP, Ames CP, Coffey S, Good C, Dahl B, Kraemer P, et al. Accuracy of Rod Contouring to Desired Angles With and Without a Template: Implications for Achieving Desired Spinal Alignment and Outcomes. Glob Spine J. 2023;13(2):425-31.
Lee TC, Chan TT, Tsang CY, Cheung CC, Cheung PH. Application of 3D printing for rod bending in long construct percutaneous pedicle screw fixation spinal surgery. J Orthop Trauma Rehabil. 2025;32(2):146-52.