Paper template–based intraoperative rod bending for percutaneous stabilization of thoracic extension-distraction fracture: illustrative case

BACKGROUND: Distraction fractures are unstable spinal injuries characterized by a horizontal fracture line through the vertebra, often occurring following deceleration mechanisms. Surgical management typically involves fixation and fusion to restore sagittal alignment. Minimally invasive approaches, including percutaneous pedicle screw fixation, have demonstrated reduced operative morbidity while achieving deformity correction comparable to that of open techniques. However, accurate rod contouring in percutaneous procedures remains technically challenging. OBSERVATIONS: A 61-year-old male presented with a three-column unstable T7 distraction fracture in the setting of diffuse idiopathic skeletal hyperostosis following a rear-end motor vehicle accident at low to moderate speeds. A T4-10 percutaneous pedicle screw fixation for fracture reduction and stabilization was performed. Preoperative CT images were formatted and printed at a 1:1 scale on a sheet of paper; cut along the fracture line, taped together to reduce the fracture, and photocopied; sterilely bagged; and used intraoperatively to guide rod bending prior to placement. LESSONS: Using a 1:1 ratio paper printout of the patient's preoperative CT scan as an anatomical template, the authors appropriately performed intraoperative rod bending without additional adjustment of rod contour. This method offers a practical, cost-effective solution to improve the precision and efficiency of rod bending in percutaneous spinal fusion. https://thejns.org/doi/10.3171/CASE26257.