# Emerging Evidence for Three-Dimensional (3D)-Printed Guide Templates in Cervical Spine Trauma Surgery: A Scoping Review

## TL;DR

3D-printed guide templates in cervical spine surgery reduce operation time, blood loss, and fluoroscopy use compared to traditional methods.

## Contribution

This scoping review provides early evidence for the feasibility of 3D-printed templates in cervical spine trauma surgery.

## Key findings

- 3DP-assisted surgery reduced operative time by 32.3 minutes compared to conventional methods.
- Intraoperative blood loss was reduced by 121.6 ml with 3D-printed guide templates.
- Fluoroscopy frequency decreased by 3.8 shots when using 3DP-assisted techniques.

## Abstract

Cervical spine fractures are complex injuries that require precise surgical fixation. Conventional freehand pedicle screw placement is associated with prolonged operative time, higher blood loss, and repeated fluoroscopy. Three-dimensional (3D) printing (3DP) offers customized patient-specific templates that may improve safety and efficiency in such cases. This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were searched for comparative studies evaluating 3DP-assisted surgery versus conventional methods in cervical spine fractures. Two reviewers independently screened, extracted data, and assessed study quality using the Methodological Index for Non-Randomized Studies (MINORS) tool. A random-effects model was used for pooled analyses, and heterogeneity was assessed with the I² statistic. Four retrospective comparative studies involving 189 patients were included. Compared with conventional freehand techniques, 3DP-assisted surgery significantly reduced operative time (mean difference: −32.3 minutes; 95%CI −38.6 to −26.0), intraoperative blood loss (mean difference: −121.6 ml; 95%CI −149.0 to −94.1), and fluoroscopy frequency (mean difference: −3.8 shots; 95%CI −4.6 to −2.9). Pain scores at 12 months were also slightly lower in the 3DP group. Heterogeneity ranged from low to moderate, and no major publication bias was identified. 3DP-assisted cervical spine surgery appears to improve operative efficiency and reduce intraoperative burden compared with conventional techniques. These findings represent early, technology-focused evidence supporting the feasibility of 3D-printed guide templates in cervical spine trauma. Given the heterogeneity of injury patterns and anatomical regions, the results should be interpreted as hypothesis-generating rather than definitive.