ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
CT vs. MRI-based synthetic CT: accuracy of thoracic and lumbar pedicle screw placement using 3D-printed guides.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- Opportunistic bone mineral density assessment in pediatric scoliosis: validating Hounsfield unit measurement from lumbar CT images.Spine deformity · 2026Article
- Opportunistic bone mineral density assessment in pediatric scoliosis: validating Hounsfield unit measurement from lumbar CT images.Spine deformity · 2026Article
- CT vs. MRI-based synthetic CT: accuracy of thoracic and lumbar pedicle screw placement using 3D-printed guides.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
purpose3D-printed patient-specific guides enable accurate pedicle screw placement in the treatment of paediatric spinal deformities. MRI-based synthetic CT (sCT) eliminates the radiation exposure associated with the preoperative planning CT, while still providing detailed bony morphology. It may therefore offer a radiation-free method for pedicle screw navigation. Thus, the aim of this study was to compare the accuracy of thoracic and lumbar pedicle screw placement using 3D-printed guides based on conventional CT versus sCT.
methodsFull-spine MRI and CT images of four human cadaveric spines were obtained, followed by AI-generation of sCTs, the digital planning of pedicle screws and 3D-printed guide manufacturing. A total of 62 K-wires were inserted, 30 sCT-based and 32 CT-based. Accuracy was evaluated by superimpose analysis of planned and achieved trajectories, and by the postoperative grading of the cortical breach rate using the Gertzbein-Robbins classification, based on projected screws along the K-wires.
resultsMedian translational entry-point deviations were 1.0 mm vertically and 0.5 mm horizontally for both sCT-based guides and CT-based guides. Angular deviations in the axial plane were 1.0˚ for sCT and 0.9˚ for CT. In the sagittal plane these were 1.8˚ and 2.1˚, respectively. No significant differences were observed between sCT and CT. Grading of pedicle's cortical breach showed no severe malposition for both sCT- and CT-based guides.
conclusionsCT matched the accuracy of conventional CT in providing source data for personalized 3D-printed guides for thoracic and lumbar pedicle screw placement in terms of translational- and angular deviations, and cortical breach rates in this cadaveric study.
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