Application of 3D printing for rod bending in long construct percutaneous pedicle screw fixation spinal surgery

A rod-and-pedicle screw construct is a common and effective surgical technique in posterior spinal instrumentation. Percutaneous pedicle screw (PPS) systems can be used in various conditions such as degenerative conditions, trauma, and malignancy. Compared to traditional open surgery, minimally invasive spine surgery (MISS) is proposed to have the advantages of less intraoperative blood loss, lower iatrogenic injury, wound complication rate, and a quicker return to daily activities. However, the contouring of rods has long been a technical challenge, especially for long constructs. Several technologies have been described to overcome this surgical difficulty, including utilizing a computer assisted method and augmented reality method for rod bending. In this article, we describe a novel technique to obtain patient-specific, prebend rods preoperatively by applying three-dimensional (3D) printing technology in a case of PPS fixation in MISS. This could save operation time and provide an alternative method for rod bending, in particular when other methods are not available. To our best knowledge, the implementation of 3D printing technology for rod-bending in minimally invasive spine surgery has never been reported before.