Optimization of the surgical technique for treating lumbosacral stenosis in dogs using personalized 3D modeling

Abstract

Two methods of performing dorsal laminectomy and stabilization of the L7-S1 segment (L7 - the last lumbar vertebra, S1 – the first sacral vertebra) using a transpedicular fixation system are presented: with and without patient-specific 3D modeling. The study included six large-breed dogs (two groups of three animals each), 6 to 13 year-old, diagnosed with lumbosacral stenosis and without contraindications for surgical treatment under general anesthesia. All animals exhibited a characteristic clinical presentation including spontaneous pain, difficulty rising, and progressive pelvic limb paresis, even during pharmacological therapy. The final diagnosis in all dogs was established based on magnetic resonance imaging (MRI); in addition, computed tomography (CT) of the lumbosacral junction was performed in the first group. All dogs underwent dorsal laminectomy and stabilization of the L7-S1 segment using a transpedicular fixation system. In the first group, surgery was performed with the use of 3D-printed patient-specific guide templates and implants for segment stabilization; in the second group, surgery was performed without individual 3D modeling. The duration of dorsal laminectomy and L7-S1 stabilization in two groups were compared. The results demonstrated that the surgical procedure using patient-specific 3D modeling (Group 1) was, on average, by 26 minutes shorter than the conventional technique, primarily due to the use of predesigned and 3D-printed guide templates that enabled precise drilling of screw channels for the fixation system.