Emerging Evidence for Three-Dimensional (3D)-Printed Guide Templates in Cervical Spine Trauma Surgery: A Scoping Review

Cervical spine fractures are complex injuries that require precise surgical fixation. Conventional freehand pedicle screw placement is associated with prolonged operative time, higher blood loss, and repeated fluoroscopy. Three-dimensional (3D) printing (3DP) offers customized patient-specific templates that may improve safety and efficiency in such cases. This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were searched for comparative studies evaluating 3DP-assisted surgery versus conventional methods in cervical spine fractures. Two reviewers independently screened, extracted data, and assessed study quality using the Methodological Index for Non-Randomized Studies (MINORS) tool. A random-effects model was used for pooled analyses, and heterogeneity was assessed with the I² statistic. Four retrospective comparative studies involving 189 patients were included. Compared with conventional freehand techniques, 3DP-assisted surgery significantly reduced operative time (mean difference: -32.3 minutes; 95%CI -38.6 to -26.0), intraoperative blood loss (mean difference: -121.6 ml; 95%CI -149.0 to -94.1), and fluoroscopy frequency (mean difference: -3.8 shots; 95%CI -4.6 to -2.9). Pain scores at 12 months were also slightly lower in the 3DP group. Heterogeneity ranged from low to moderate, and no major publication bias was identified. 3DP-assisted cervical spine surgery appears to improve operative efficiency and reduce intraoperative burden compared with conventional techniques. These findings represent early, technology-focused evidence supporting the feasibility of 3D-printed guide templates in cervical spine trauma. Given the heterogeneity of injury patterns and anatomical regions, the results should be interpreted as hypothesis-generating rather than definitive.