Spinal Neuronavigation and 3D-Printed Tubular Guide for Pedicle Screw Placement: A Really New Tool to Improve Safety and Accuracy of the Surgical Technique?

During the last years in spine surgery has become more urgent the need for a safe method to improve pedicle screw placement. A safe and correct placement can have many important consequences, both clinical (development of new symptoms) and medico-legal. The most widespread and used tool is neuronavigation. In literature, many studies have compared the precision of screw placement between free-hand, fluoroscopic guided technique and neuronavigation [1]. Data from the literature seem to show a higher precision of neuronavigation, if compared to the other two classic techniques, even if some studies seem to show a lower precision in the thoracic spine [2]. A recent developed technology is based on the use of tubular guides realized with a 3D printer. This new technology has been currently developed, and only few patients have been treated, so that is too early to express a definitive judgment. In this editorial, we will be analysing the characteristics of both systems, with both their pros and cons.