{"id":{"repo_id":"uiuc","oai_identifier":"oai:www.ideals.illinois.edu:2142/115890"},"canonical_url":"https://search.dev.ndltd.org/etd/uiuc/oai:www.ideals.illinois.edu:2142/115890","repository":{"repo_id":"uiuc","name":"University of Illinois - Urbana-Champaign","base_url":"https://www.ideals.illinois.edu/oai-pmh"},"display":{"title":"Performance comparison between three-dimensionally printed patient-specific drill guides and the conventional free-hand technique for vertebral implant placement in the canine thoracolumbar spine: An ex-vivo study","abstract":"Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2024-08-01","abstract_html":"Submission published under a 24 month embargo labeled &#x27;Closed Access&#x27;, the embargo will last until 2024-08-01","abstract_has_math":false,"creators":["Guevara, Francisco"],"institution":"University of Illinois at Urbana-Champaign","degree_name":"M.S.","degree_level":"Thesis","degree_discipline":"VMS-Veterinary Clinical Medcne","degree_department":null,"school":null,"contributors":["Foss, Kari D.","Hauge, Devon W.","Moran, Clara E.","Harper, Tisha A."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022-08","date_published":"2022-08","updated_at":"2026-07-22T22:24:55Z","subjects":["Dog","3D-printing","Spine","Surgery"],"languages":["en","eng"],"rights":["Copyright 2022 Francisco Guevara"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2142/115890","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Foss, Kari D.","Hauge, Devon W.","Moran, Clara E.","Harper, Tisha A."]},{"key":"dc:creator","label":"Author","values":["Guevara, Francisco"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2022-08","2022-07-08"]},{"key":"dc:type","label":"Dc Type","values":["text","Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["VMS-Veterinary Clinical Medcne"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["M.S."]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["University of Illinois at Urbana-Champaign"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Dog","3D-printing","Spine","Surgery"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en","eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Copyright 2022 Francisco Guevara"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://hdl.handle.net/2142/115890"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2024-08-01","The student, Francisco Guevara, accepted the attached license on 2022-07-06 at 17:49.","The student, Francisco Guevara, submitted this Thesis for approval on 2022-07-06 at 17:59.","This Thesis was approved for publication on 2022-07-08 at 17:13.","DSpace SAF Submission Ingestion Package generated from Vireo submission #18157 on 2022-11-16 at 10:17:45","Surgical stabilization of the vertebral column is often indicated for dogs with severe myelopathic signs and/or refractory pain secondary to spinal instability. Among various spinal fixation techniques described in the veterinary literature, pin or screw and polymethyl methacrylate (PMMA) constructs are used most commonly. Although this technique is an accepted standard of care, it is technically challenging and can lead to life-threatening complications. Experimental studies in canine cadavers have reported rates of spinal canal breach ranging from 19% to 100%, during bicortical implant placement in the lumbar and cervical spine respectively. Several studies have investigated the application of 3D printed drill guides in the canine spine and have demonstrated the feasibility and safety of this technique. However, these studies focused on a specific region of the spine (cervical, thoracic, or lumbosacral). Additionally, in these studies, only 1-2 individuals performed placement of the implants with a small number of vertebrae evaluated. Further investigation into the utilization of 3D printing techniques over the entire canine spine and their use by surgeons with varying degrees of skillsets are warranted to continue to determine the application and safety. The objective of this study was to compare performance between 3D printed patient- specific drill guides (3DPG) and the conventional free-hand technique (FH) for vertebral implant placement in canine cadaveric thoracolumbar spines. We hypothesized that the use of computed tomography (CT) -based patient-specific vertebral drill guides would result in significantly more accurate placement of bicortical implants in the canine cadaveric spine compared to the conventional free-hand technique. Twenty-four medium-to-large-breed canine cadavers were utilized for this study. CT of each cadaveric spine was performed, and optimal implant trajectories were established for both the left and right sides of the T10 through L6 vertebra. CT data was then used to create patient- specific drill-guides for the vertebrae of interest. Each cadaver was randomly assigned to 1 of 6 veterinarians (two board-certified surgeons, two board-certified neurologists, one surgery resident, and one neurology resident) with varying levels of experience placing vertebral implants. For each cadaver, vertebrae were randomly assigned a surgical order and technique (3DPG or FH) for both right and left sides. Following implant placement, postoperative CT images were acquired, and performance of pin placement was assessed using a modified Zdichavsky classification by a single, blinded observed. A total of 480 implants were placed in 240 vertebrae. Three sites were excluded from analysis due to surgeon error; therefore, a total of 238 implants were placed using the FH technique and 239 implants were placed using 3DPG. When evaluating implant placement, 152/239 (63.6%) of implants were considered to be optimally placed using 3DPG compared to 115/248 (48.32%) with FH. Overall, pin placement using 3DPG was significantly more accurate (P<0.001) compared to the FH technique. This study demonstrates that the use of 3DPG is superior to that of utilizing a free-hand technique in regard to implant accuracy. While 63.6% of implants were scored a Grade I (optimal placement) using the 3DPG technique, 87% were a Grade I or IIa compared to only 69% as Grade I or IIa when placed via FH technique. While Grade I is considered optimal placement, clinically, Grade I or Grade IIa are considered acceptable. This study demonstrated that utilizing 3DPG led to better performance with placing implants in the canine thoracolumbar spine compared to the traditional FH technique and the 3DPG technique was able to be utilized by all surgeons with varying degrees of experience. Additional studies utilizing this technique in a clinical setting are warranted."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Performance comparison between three-dimensionally printed patient-specific drill guides and the conventional free-hand technique for vertebral implant placement in the canine thoracolumbar spine: An ex-vivo study"]}]}],"canonical_facts":{"dc:contributor":["Foss, Kari D.","Hauge, Devon W.","Moran, Clara E.","Harper, Tisha A."],"dc:creator":["Guevara, Francisco"],"dc:date":["2022-08","2022-07-08"],"dc:description":["Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2024-08-01","The student, Francisco Guevara, accepted the attached license on 2022-07-06 at 17:49.","The student, Francisco Guevara, submitted this Thesis for approval on 2022-07-06 at 17:59.","This Thesis was approved for publication on 2022-07-08 at 17:13.","DSpace SAF Submission Ingestion Package generated from Vireo submission #18157 on 2022-11-16 at 10:17:45","Surgical stabilization of the vertebral column is often indicated for dogs with severe myelopathic signs and/or refractory pain secondary to spinal instability. Among various spinal fixation techniques described in the veterinary literature, pin or screw and polymethyl methacrylate (PMMA) constructs are used most commonly. Although this technique is an accepted standard of care, it is technically challenging and can lead to life-threatening complications. Experimental studies in canine cadavers have reported rates of spinal canal breach ranging from 19% to 100%, during bicortical implant placement in the lumbar and cervical spine respectively. Several studies have investigated the application of 3D printed drill guides in the canine spine and have demonstrated the feasibility and safety of this technique. However, these studies focused on a specific region of the spine (cervical, thoracic, or lumbosacral). Additionally, in these studies, only 1-2 individuals performed placement of the implants with a small number of vertebrae evaluated. Further investigation into the utilization of 3D printing techniques over the entire canine spine and their use by surgeons with varying degrees of skillsets are warranted to continue to determine the application and safety. The objective of this study was to compare performance between 3D printed patient- specific drill guides (3DPG) and the conventional free-hand technique (FH) for vertebral implant placement in canine cadaveric thoracolumbar spines. We hypothesized that the use of computed tomography (CT) -based patient-specific vertebral drill guides would result in significantly more accurate placement of bicortical implants in the canine cadaveric spine compared to the conventional free-hand technique. Twenty-four medium-to-large-breed canine cadavers were utilized for this study. CT of each cadaveric spine was performed, and optimal implant trajectories were established for both the left and right sides of the T10 through L6 vertebra. CT data was then used to create patient- specific drill-guides for the vertebrae of interest. Each cadaver was randomly assigned to 1 of 6 veterinarians (two board-certified surgeons, two board-certified neurologists, one surgery resident, and one neurology resident) with varying levels of experience placing vertebral implants. For each cadaver, vertebrae were randomly assigned a surgical order and technique (3DPG or FH) for both right and left sides. Following implant placement, postoperative CT images were acquired, and performance of pin placement was assessed using a modified Zdichavsky classification by a single, blinded observed. A total of 480 implants were placed in 240 vertebrae. Three sites were excluded from analysis due to surgeon error; therefore, a total of 238 implants were placed using the FH technique and 239 implants were placed using 3DPG. When evaluating implant placement, 152/239 (63.6%) of implants were considered to be optimally placed using 3DPG compared to 115/248 (48.32%) with FH. Overall, pin placement using 3DPG was significantly more accurate (P<0.001) compared to the FH technique. This study demonstrates that the use of 3DPG is superior to that of utilizing a free-hand technique in regard to implant accuracy. While 63.6% of implants were scored a Grade I (optimal placement) using the 3DPG technique, 87% were a Grade I or IIa compared to only 69% as Grade I or IIa when placed via FH technique. While Grade I is considered optimal placement, clinically, Grade I or Grade IIa are considered acceptable. This study demonstrated that utilizing 3DPG led to better performance with placing implants in the canine thoracolumbar spine compared to the traditional FH technique and the 3DPG technique was able to be utilized by all surgeons with varying degrees of experience. Additional studies utilizing this technique in a clinical setting are warranted."],"dc:format":["application/pdf"],"dc:identifier":["https://hdl.handle.net/2142/115890"],"dc:language":["en","eng"],"dc:rights":["Copyright 2022 Francisco Guevara"],"dc:subject":["Dog","3D-printing","Spine","Surgery"],"dc:title":["Performance comparison between three-dimensionally printed patient-specific drill guides and the conventional free-hand technique for vertebral implant placement in the canine thoracolumbar spine: An ex-vivo study"],"dc:type":["text","Thesis"],"thesis:degree_discipline":["VMS-Veterinary Clinical Medcne"],"thesis:degree_level":["Thesis"],"thesis:degree_name":["M.S."],"thesis:institution_name":["University of Illinois at Urbana-Champaign"]},"updated_at":"2026-07-22T22:24:55Z"}