🔍 Key Findings
- Both free-hand probing (FHP) and 3D-printed guides (3DPG) enabled accurate spinal pin placement, with 87.5% vs 96.4% of pins graded as optimal (Grade I).
- 3DPGs had fewer intraoperative deviations (0/56 pins) compared to 6/56 with the FHP technique.
- No pins using either method fully breached the medial vertebral canal (Grade IIb) — a critical safety outcome.
- Pins placed using 3DPGs required less time overall (mean 2.6 min) than FHP (mean 4.5 min).
- FHP required specific experience and has a learning curve, whereas 3DPG use requires CAD software and 3D printing access.
- FHP had more lateral canal violations (Grade IIIa: 4/56 vs 0/56 for 3DPG), suggesting slightly less precision.
- Both techniques were safe, and all deviations were recognized and corrected intraoperatively.
- 3DPGs may offer practical advantages in clinical settings lacking surgical expertise, while FHP allows immediate intervention without 3D printing delay.

