Abstract
ABSTRACT
Objective
Precise resection of sacral tumors remains technically demanding due to their deep anatomical location and close proximity to critical neurovascular structures. Conventional freehand techniques often result in suboptimal resection margins, excessive blood loss, and compromised lumbopelvic stability. This study evaluated whether patient‐specific three‐dimensional (3D)‐printed guiding templates improve surgical accuracy and perioperative outcomes in sacral tumor resection and reconstruction.
Methods
Nineteen patients undergoing en bloc sacral tumor resection (S1–S3 involvement) with spinopelvic reconstruction (2006–2020) were retrospectively analyzed. Patients were divided into a 3D‐printing group (
n
= 10) and a conventional freehand group (
n
= 9). In the 3D‐printing group, computer‐aided design and 3D‐printed templates were used for osteotomy, screw placement, and defect reconstruction. Perioperative metrics, surgical accuracy, and complications were compared between groups using Welch's
t
‐test and the Hodges–Lehmann method; oncologic events during follow‐up were recorded descriptively.
Results
The 3D‐printing group demonstrated significantly shorter operative time (456.5 ± 62.36 vs. 574.44 ± 114.58 min,
p
= 0.012), reduced blood loss (4081.40 ± 838.99 vs. 5090.0 ± 1059.67 mL,
p
= 0.034), and fewer fluoroscopic exposures (4.2 ± 0.79 vs. 10.0 ± 1.58,
p
p
= 0.0012). Postoperative complication rates were comparable (30% vs. 44.4%,
p
= 0.649), but hospital stay was significantly shorter in the 3D‐printing group (10.7 ± 2.71 vs. 18.11 ± 4.01 days,
p
Conclusion
Patient‐specific 3D‐printed guiding templates enhance precision in sacral tumor excision and reconstruction, improving surgical efficiency and perioperative safety. This computer‐assisted, template‐guided approach represents a valuable advancement for complex sacral oncologic surgery.