PMC9458159_01
Plain lumbar X-ray and MRI for case 1. This patient was a 59-year-old man. T2 MRI at L4-L5 indicated severe foraminal stenosis on the right.
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Plain X-ray revealed severe lumbar deformity (Fig. 1A, B), and magnetic resonance imaging (MRI) and computed tomography (CT) showed severe foraminal stenosis at the right L4-L5 level (Figs. 1C, D and 2A, B).
CT and 3D printing models for case 1. (A, B, and C) Before surgery. (D, E, and F) After surgery. Postoperative CT and the 3D printing model showed an enlarged foramen of L4-L5.
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In FELF, the superior articular process (SAP) was shaved by a high-speed bar using the transforaminal approach.) Because the lumbar deformity and osteophytes contributed to severe foraminal and spinal canal stenosis, we employed 3D printing for preoperative planning (Fig. 2C). Postoperative CT (Fig. 2D, E) revealed an enlarged foramen of L4-L5. We confirmed the extent of the bone shaving using postoperative 3D printing (Fig. 2F).
PMC9458159_02
Plain lumbar X-ray and MRI for case 2. This patient was a 75-year-old woman. T2 MRI at L5-S indicated severe foraminal stenosis on the right.
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Plain X-ray (Fig. 3A, B), MRI (Fig. 3C, D), and CT (Fig. 4A, B) revealed severe deformity and osseous foraminal stenosis caused by osteophytes of the L5-S facet joints, which resulted in right L5 nerve root radiculopathy.
CT scan and 3D model for case 2. (A, B, and C) Before surgery. (D, E, and F) After surgery. Postoperative CT and the 3D printing model showed an enlarged foramen of L5-S.
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Plain X-ray (Fig. 3A, B), MRI (Fig. 3C, D), and CT (Fig. 4A, B) revealed severe deformity and osseous foraminal stenosis caused by osteophytes of the L5-S facet joints, which resulted in right L5 nerve root radiculopathy. Using preoperative 3D printing, we simulated the cannula insertion and the area for shaving of the SAP of S1 (Fig. 4C). Postoperative CT scans revealed foraminal enlargement (Fig. 4D, E), and the postoperative 3D printing model clearly showed that the extent of the bone shaving matched that of the preoperative plan (Fig. 4F).