Novel 3D Navigation Technology for a Personalized Surgical Approach in Diastematomyelia

Background : Type 1 diastematomyelia is a rare congenital spinal anomaly in which the spinal cord is separated by an osseous septum into 2 hemicords. Pediatric patients often present with neurological disorders and spinal deformities, which significantly impair their quality of life. Conventional surgical treatment includes septal resection and osteoplastic laminotomy but is often accompanied by significant traumatization, risks of damage to neural structures, increased intraoperative blood loss, iatrogenic spinal instability, and postlaminectomy spinal deformity progression. Modern 3D technologies enable to improve the accuracy of surgery, ensuring gentler treatment of the posterior spinal structures. Objective : To compare the effectiveness and safety of an individualized navigation template for osteoplastic laminotomy with those of the traditional surgical approach in patients with type 1 diastematomyelia. Materials and methods : The retrospective study included 13 patients (age, 4-12 years) with type 1 diastematomyelia. In the main group (n=6), we used individualized 3D navigation templates, whereas the control group (n=7) underwent conventional laminotomy. The data (operation time, blood loss volume, C-reactive protein level, complications) were analyzed using Statistica (TIBCO Software Inc, USA). Quantitative values were compared using a t test, and P < .05 was considered statistically significant. Results : The application of the navigation template significantly reduced osteotomy duration and blood loss compared with the conventional method (P < .05). The C-reactive protein level on the first postoperative day did not differ significantly between the groups (P > .05), indicating a similar postoperative inflammatory response. One control patient had a neurological complication, which resolved within 3 months. Conclusions : An individualized navigation template for type 1 diastematomyelia increases the accuracy of bone resection and reduces the traumatic nature of the surgery. This approach holds promise for its widespread implementation in clinical practice, particularly in cases of complex congenital spinal anomalies.