中国组织工程研究2015，Vol.19Issue(17)：2752-2757,6.DOI:10.3969/j.issn.2095-4344.2015.17.023
基于3D打印的腰椎椎弓根螺钉数字化置入及临床应用
Digital placement and clinical application of lumbar pedicle screws based on 3D printing
陈宣煌 1许卫红 2黄文华 3林海滨 1张国栋 1吴长福 3陈旭 1余正希1
作者信息
- 1. 福建医科大学教学医院,南方医科大学附属莆田医院,莆田学院附属医院骨科,福建省莆田市 351100
- 2. 福建医科大学附属第一医院脊柱外科,福建省福州市 350005
- 3. 南方医科大学基础医学院人体解剖学教研室,广东省广州市 510515
- 折叠
摘要
Abstract
BACKGROUND:3D printing to prepare individualized navigation template-assisted screw placement can elevate screw placement accuracy of spinal pedicle screw,and have good prospects for clinical application.OBJECTIVE:To investigate the method of lumbar pedicle screw navigation placement using digital design of Mimics software combined with 3D printing module,and to explore its feasibility and accuracy.METHODS:From February 2012 to August 2013,a total of 60 patients with lumbar diseases underwent 3D printing module-assisted lumbar pedicle screw navigation placement.Al patients received continuous thin slice CT scan.We colected Dicom format images.Mimics software was used for 3D reconstruction to design screw channel and the supporting column of lumbar pedicle screw placement and to divide strippable bone surface,to design navigation module with screw channel,and then to carry out 3D printing.Navigation module was utilized for navigation screw placement during the surgery.The position and replacement of screw were observed.X-ray and CT scan were applied to assess the outcomes of screw placement.The patients were folowed up for (12.17±3.21) months.Oswestry Disability Index was employed to evaluate the improvement of lumbar function.Japanese Orthopaedic Association (low back pain) scoring system was used to assess the therapeutic effects.RESULTS AND CONCLUSION:253 navigation modules were made and 253 screws were implanted.Screw channel and postoperative bone surrounding the vertebral body were observed,and no breakage was found.Postoperative X-ray and CT scan revealed that the direction of eight pedicle screws was migrated compared with preoperative design,but their positions were stil satisfactory.The placement site,direction and length of 245 pedicle screws were consistent with the desired site,direction and length in Mimics software,with an accuracy of 96.84％.The navigation module was tightly connected to bone structure in front of the corresponding vertebral body,with good chimeric degree.During application,the position and stability were good.During final folow-up,Japanese Orthopaedic Association score increased,and Oswestry Disability Index was lower compared with pre-operation (P＜0.01),with an excelent and good rate of 95％.Above results confirmed that with the aid of navigation module,the digital placement of lumbar pedicle screws was precise,characterized by less complications and good therapeutic effects,and contributed to the recovery of lumbar function in patients.关键词
植入物/数字化骨科/腰椎/椎弓根螺钉/数字化设计/3D打印/手术导航/个体化导航模板/置钉准确率/计算机辅助设计分类
医药卫生引用本文复制引用
陈宣煌,许卫红,黄文华,林海滨,张国栋,吴长福,陈旭,余正希..基于3D打印的腰椎椎弓根螺钉数字化置入及临床应用[J].中国组织工程研究,2015,19(17):2752-2757,6.
