Application of 3D Printing Guide Plate in Endoscopic Spinal Surgery

Not Applicable

Not yet recruiting

• Conditions: Lumbar Spinal Stenosis; Lumbar Disc Herniation; Radicular Pain; Low Back Pain
• Interventions: Other: 3D printing guide plate; Other: Conventional guidance

• Registration Number: NCT05632835
• Lead Sponsor: Peking University Third Hospital

Brief Summary

Application of 3D printing guide plate in endoscopic spinal surgery

Detailed Description

This study applies 3D-printed customized guide plate in assisting the accurate puncture in endoscopic spinal surgeries, in patients with low back pain, lumbosacral radicular pain, abnormal sensation or muscle strength or reflex of lower extremity, cauda equina syndrome, etc. This technique can shorten reduce the intra-operative radiation, and do not affect the surgical outcome.

This study involved diseases such as lumbar disc herniation, lumbar spinal stenosis, radiculopathy, disc degeneration, etc. Endoscopic spinal surgeries are effective treatments for these disease. Needle Puncture is the key technology in endoscopic spinal surgeries.

In the past when there were no customized guides, the surgeons would place the needle according to his/her previous experience under the guidance of C-arm fluoroscopy or CT. If the position of the needles is not satisfactory, repeated procedure will be performed. This would lead to an increase in the duration of surgery and intra-operative radiation, which is detrimental to both the surgeon and the patient. This problem could be well solved by applying the 3D printing guide plate.

The key processes for the 3D printing guide plate procedure: the model of the spine or bone is established according to the patient's CT scan data to prepare the customized guide plate, then sterilize them for future use. The final position of needle is confirmed by C-arm fluoroscopy or CT or evoked pain.

Study Timeline

• Status Verified: 2022-09
• Study First Submitted: 2022-10-29
• Study First Submitted QC: 2022-11-20
• Last Update Submitted: 2022-11-20
• Study Start: 2022-11-25
• Study First Posted: 2022-12-01
• Last Update Posted: 2022-12-01
• Primary Completion: 2023-08-31
• Study Completion: 2023-12-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 28

Inclusion Criteria

1. Age ≥18 years old;
2. Pain lasting ≥12 weeks;
3. The previous failure of conservative management such as physiotherapy, exercise therapy, or analgesic medications;
4. Pain intensity≥4 out of 10 on the numerical rating scale (NRS);
5. Availability of computed tomography/magnetic resonance imaging findings of pathology concordant with the side and level of their clinical features;
6. Agree with endoscopic spinal surgeries.

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Exclusion Criteria

1. Patient refusal to participate in the study;
2. Pregnant or nursing;
3. Allergies to local anesthetics, contrast dyes or steroids;
4. Significant anatomic deformity (either congenital or acquired) making it difficult to access the target as evidenced by computed tomography/magnetic resonance imaging;
5. Patients with platelet dysfunction, bleeding disorder or continuing anticoagulant treatment;
6. Systemic infection;
7. Injection site infection;
8. Unstable medical or psychiatric condition;
9. Unable to tolerate the surgeries.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
3D printing guide plate group	3D printing guide plate	3D-printed customized guide plate will be used to guide the puncture in endoscopic spinal surgeries.
Conventional guidance group	Conventional guidance	The surgeons would place the needle according to his/her previous experience under the guidance of C-arm fluoroscopy or CT.

Primary Outcome Measures

Name	Time	Method
C-arm fluoroscopy times	Intraoperative	Numbers of using C-arm fluoroscopy

Secondary Outcome Measures

Name	Time	Method
Numerical rating scale	Postoperative 1 day, 2 weeks, 1 month	Numerical rating scale (NRS) at 1 day, 2 weeks, 1 month after the operation, with 0-10 numbers and 10 represents most worse condition
Patient satisfaction	Postoperative 1 months	Patient satisfaction using the modified MacNab criteria (MacNab)
Puncture time	Intraoperative	Time from the first puncture to the last puncture
Rate of Complications	Intraoperative	Rate of Complications like nerve injury, blood, hemotoma, etc.

Trial Locations

Locations (1)

Pain medicine center of Peking University Third Hospital; 🇨🇳 Beijing, Beijing, China