BACKGROUND Many surgeons believe that the use of a 3D-printed drill guide template shortens operative time and reduces intraoperative blood loss compared with those of the free-hand technique. In this study, we investigated the effects of a drill guide template on the accuracy of pedicle screw placement (the screw placed completely in the pedicle), operative time, and intraoperative blood loss. MATERIALS/METHODS We systematically searched the major databases, such as Medline via PubMed, EMBASE, Ovid, Cochrane Library, and Google Scholar, regarding the accuracy of pedicle screw placement, operative time, and intraoperative blood loss. The χ2 test and I2 statistic were used to examine heterogeneity. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the accuracy rate of pedicle screw placement, and weighted mean differences (WMDs) with 95% CIs were utilized to express operative time and intraoperative blood loss. RESULTS This meta-analysis included 13 studies (seven randomized controlled trials and six prospective cohort studies) involving 446 patients and 3375 screws. The risk of research bias was considered moderate. Operative time (WMD = - 20.75, 95% CI - 33.20 ~ - 8.29, P = 0.001) and intraoperative blood loss (WMD = - 106.16, 95% CI - 185.35 ~ - 26.97, P = 0.009) in the thoracolumbar vertebrae, evaluated by a subgroup analysis, were significantly different between groups. The 3D-printed drill guide template has advantages over the free-hand technique and improves the accuracy of pedicle screw placement (OR = 2.88; 95% CI, 2.39~3.47; P = 0.000). CONCLUSION The 3D-printed drill guide template can improve the accuracy rate of pedicle screw placement, shorten operative time, and reduce intraoperative blood loss.

中文翻译：

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使用3D打印的钻孔指导模板在脊柱神经外科中进行椎弓根螺钉放置：系统评价和荟萃分析。

背景技术许多外科医生认为，与徒手技术相比，使用3D打印的钻孔导向模板可缩短手术时间并减少术中失血。在这项研究中，我们研究了钻孔引导模板对椎弓根螺钉放置的准确性（螺钉完全放置在椎弓根中），手术时间和术中失血的影响。材料/方法我们通过PubMed，EMBASE，Ovid，Cochrane Library和Google Scholar系统搜索了主要数据库，例如Medline，以了解椎弓根螺钉放置，手术时间和术中失血的准确性。χ2检验和I2统计量用于检验异质性。具有95％置信区间（CI）的几率（OR）用于计算椎弓根螺钉放置的准确率，使用具有95％CI的加权均数差（WMD）来表示手术时间和术中失血。结果这项荟萃分析包括13项研究（七项随机对照试验和六项前瞻性队列研究），涉及446例患者和3375枚螺钉。研究偏倚的风险被认为是中等的。评估胸腰椎手术时间（WMD =-20.75，95％CI-33.20〜-8.29，P = 0.001）和术中失血（WMD =-106.16，95％CI-185.35〜-26.97，P = 0.009），评估通过亚组分析，各组之间存在显着差异。3D打印的钻孔引导模板优于徒手技术，并提高了椎弓根螺钉放置的精度（OR = 2.88； 95％CI，2.39〜3.47； P = 0.000）。