Clinical efficacy of 3D-printed guide plates in single-level lumbar degenerative disease: a retrospective comparative study

To evaluate the clinical efficacy of 3D-printed guide plate-assisted pedicle screw placement for single-level lumbar degenerative diseases. A retrospective comparative study was conducted on 60 patients who underwent surgical pedicle screw placement and interbody fusion due to lumbar degenerative diseases from January 2023 to December 2023. Patients were divided into two groups: a test group (n=30) using 3D-printed guide plates for individualized pedicle screw placement and a control group (n=30) using traditional freehand techniques. Operation time, pedicle screw placement time, intraoperative fluoroscopy exposure, blood loss, and postoperative complications were compared between the two groups. Additionally, Visual Analogue Scale (VAS) scores and the Oswestry Disability Index (ODI) were assessed at 1, 6, and 12 months postoperatively. The operation time, screw placement time, intraoperative fluoroscopy exposures, and blood loss in the test group were 63.57 ± 12.18 min, 23.69 ± 3.63 min, 15.26 ± 4.15 times, and 48.82 ± 13.72 ml, respectively, significantly lower than those in the control group (85.56 ± 16.27 min, 41.36 ± 8.12 min, 26.96 ± 6.93 times, and 74.35 ± 18.64 ml; P < 0.05). In the test group, screw placement accuracy was 97.5% (117 screws of Grade 0, 3 screws of Grade 1), significantly higher than the control group's accuracy of 88.33% (106 screws of Grade 0, 13 screws of Grade 1, and 1 screw of Grade 2; P < 0.05). Although postoperative VAS scores and ODI values statistically improved over time (P <0.05), no statistically significant difference was found between groups at the same time points (P<0.05). No postoperative complications were reported. 3D-printed guides can improve screw placement accuracy and operative efficiency. However, for routine single-level lumbar degenerative disease, clinical outcomes were not superior to conventional methods. Broader studies are needed to establish their cost-effectiveness and long-term benefit.