Objective To evaluate the safety and practicality of 3D printing guide plate in assisting complex upper cervical pedicle screw implantation.

Methods According to the characteristics of upper cervical pedicle and common clinical methods of pinning, three-dimensional CT of the cervical vertebra was performed, the rapid prototyping technology was used to design and print individualized solid cervical vertebra models and guidance templates of patients with upper cervical vertebra diseases, and the pinning was assisted by guide plate. The preoperative CT 3D data of 24 patients with fracture and deformity of upper cervical vertebra were selected to print 2 copies of upper cervical vertebra models. The observation group was simulated with pedicle screw implantation assisted by personalized 3D printing guide plate. The control group was assisted by fluoroscopy, and the pedicle screw was implanted by hand. The time of single screw implantation, adjustment times of single screw and fluoroscopy times were compared between two groups, and the postoperative CT was reviewed to evaluate the accurate rate of nail implantation.

Results The single screw planting time, single screw adjustment times and fluoroscopy times in the observation group were significantly less than those in control group (P ＜ 0.01). The results of postoperative CT examination showed that the accuracy rate of the observation group was 96.74% (89/92), which was significantly higher than that of control group (82.61%) (76/92) (P ＜ 0.01).

Conclusions Compared with manual screw implantation, the pedicle screw implantation assisted by 3D printing guide plate is safer, more efficient, more accurate and more convenient, which breaks the limitations of the original operation, and is worthy of clinical promotion.