{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:17:28Z","timestamp":1788315448623,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020084","name":"Guangzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["2025A03J3257"],"award-info":[{"award-number":["2025A03J3257"]}],"id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Precise resection of sacral tumors remains technically demanding due to their deep anatomical location and close proximity to critical neurovascular structures. Conventional freehand techniques often result in suboptimal resection margins, excessive blood loss, and compromised lumbopelvic stability. This study evaluated whether patient\u2010specific three\u2010dimensional (3D)\u2010printed guiding templates improve surgical accuracy and perioperative outcomes in sacral tumor resection and reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Nineteen patients undergoing en bloc sacral tumor resection (S1\u2013S3 involvement) with spinopelvic reconstruction (2006\u20132020) were retrospectively analyzed. Patients were divided into a 3D\u2010printing group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910) and a conventional freehand group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099). In the 3D\u2010printing group, computer\u2010aided design and 3D\u2010printed templates were used for osteotomy, screw placement, and defect reconstruction. Perioperative metrics, surgical accuracy, and complications were compared between groups using Welch's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test and the Hodges\u2013Lehmann method; oncologic events during follow\u2010up were recorded descriptively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 3D\u2010printing group demonstrated significantly shorter operative time (456.5\u2009\u00b1\u200962.36 vs. 574.44\u2009\u00b1\u2009114.58\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), reduced blood loss (4081.40\u2009\u00b1\u2009838.99 vs. 5090.0\u2009\u00b1\u20091059.67\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034), and fewer fluoroscopic exposures (4.2\u2009\u00b1\u20090.79 vs. 10.0\u2009\u00b1\u20091.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with the conventional group. Osteotomy accuracy was also superior in the 3D\u2010printing group, with significantly lower angular deviation (3.33\u00b0\u2009\u00b1\u20090.45\u00b0 vs. 6.79\u00b0\u2009\u00b1\u20092.16\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0012). Postoperative complication rates were comparable (30% vs. 44.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.649), but hospital stay was significantly shorter in the 3D\u2010printing group (10.7\u2009\u00b1\u20092.71 vs. 18.11\u2009\u00b1\u20094.01\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient\u2010specific 3D\u2010printed guiding templates enhance precision in sacral tumor excision and reconstruction, improving surgical efficiency and perioperative safety. This computer\u2010assisted, template\u2010guided approach represents a valuable advancement for complex sacral oncologic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70383","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:33:57Z","timestamp":1785130437000},"page":"1847-1860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of Three\u2010Dimensionally Printed Surgical Guides in Precise Sacral Tumor Excision and Defect Reconstruction"],"prefix":"10.1111","volume":"18","author":[{"given":"Yansong","family":"Liu","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine Southern Medical University  Guangzhou Guangdong China"},{"name":"Department of Orthopedics General Hospital of Southern Theater Command  Guangzhou Guangdong 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongbiao","family":"Liang","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine Southern Medical University  Guangzhou Guangdong China"},{"name":"Department of Orthopedics General Hospital of Southern Theater Command  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningling","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopedics General Hospital of Southern Theater Command  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renxuan","family":"Tu","sequence":"additional","affiliation":[{"name":"Shenzhen College of International Education  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Tu","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine Southern Medical University  Guangzhou Guangdong China"},{"name":"Department of Orthopedics General Hospital of Southern Theater Command  Guangzhou Guangdong China"},{"name":"School of Medicine South China University of Technology  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.03.042"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2012.06.014"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.106B1.BJJ-2023-0594.R1"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.9.SPINE09728"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-01152-9"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.07.047"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03207-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198011000-00013"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1883-6"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990215)85:4<878::AID-CNCR15>3.0.CO;2-7"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41205-025-00295-6"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453677608988751"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000229331.14029.44"},{"issue":"10","key":"e_1_2_13_15_1","first-page":"1536","article-title":"Research 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