Evaluation of the efficacy of a novel customized guide with visual control function in children with congenital spinal deformity

BACKGROUND: The use of customized surgical guides for transpedicular screw placement improves the accuracy and safety of the procedure in children with congenital spinal deformities. AIM: The aim of the study was to develop and perform a comparative analysis of the effectiveness of a new surgical guide with cutouts for visual control during transpedicular screw placement in pediatric patients with congenital spinal deformities associated with thoracic curvatures. MATERIALS AND METHODS: The study included 30 patients with congenital deformities of the spine and thorax who underwent surgery between June 2022 and June 2023. The patients were divided into the group that used the new guide and the group that used the freehand technique. Screw placement accuracy was assessed using the Gertzbein scale based on postoperative computed tomography data. Results were compared using Student’s t-test for independent samples because the data were normally distributed, as verified by the Shapiro–Wilk test. Statistical significance was defined as a p 0.05. RESULTS: The new guide demonstrated high accuracy, with 97.7% of screws placed without deviation (Grade 0). Only 2.3% of the screws deviated up to 2 mm (Grade I), which did not affect the complication rates. The freehand technique had lower accuracy rates; approximately 89.7% of the screws were placed correctly (Grade 0), 7.5% had a deviation of up to 2 mm (Grade I), and 2.8% had a deviation of more than 2 mm (Grade II and above). CONCLUSIONS: A new customized guide with visual control cutouts provides high accuracy, reliability and ease of use, making it a promising clinical tool for treating congenital spinal deformities.