Computer-assisted planning and patient-specific instruments for bone tumor surgery within the pelvis – an experimental study

Resecting bone tumors within the pelvis is challenging due to the complex geometry, limited visibility and restricted workspace of the pelvic bone. Tumor resection requires good cutting accuracy to achieve satisfactory margins and avoid the risk of local recurrence. Computer-assisted technologies have been developed for pelvic bone tumor surgeries to improve cutting accuracy. Preoperative planning and intraoperative navigation are available for the positioning of surgical tools (chisels, burrs, saws…) [1]: clinical studies already have demonstrated the feasibility of achieving tumor-free resection margins within the pelvis with the aid of these assistance technologies. Patient-specific instrumentation technology has been developed as an alternative to intraoperative navigation. Commercially available patient-specific instruments exist for total knee arthroplasty [2], pedicle screw insertion [3] and pelvic osteotomy [4]. To date, no studies have reported accuracy data on achieved margins during pelvic bone tumor resections with patient-specific instruments. This experimental study investigated the accuracy of patient-specific instrumentation technology for bone cutting during simulated tumor surgeries within the pelvis.