颈椎弓根置钉植入的新型3D打印导板有效性研究

张昊; 胡亚威; 刘阳; 王建华; 李学仕; 马立敏; 周建华; 菅新民; 陈少初; 张弦; 卢学有

doi:10.13418/j.issn.1001-165x.2017.02.006

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (2) : 147-150. DOI: 10.13418/j.issn.1001-165x.2017.02.006

3D打印技术

颈椎弓根置钉植入的新型3D打印导板有效性研究

张昊¹，　胡亚威¹，　刘阳²，　王建华³，　李学仕⁴，　马立敏³，　周建华¹　
菅新民¹，　陈少初¹，　张弦¹，　卢学有¹

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The feasibility study of cervical pedicle screwed with new individual-oriented template by 3D printing technology

ZHANG Hao¹, HU Ya-wei¹, LIU Yang², WANG Jian-hua³, LI Xue-shi⁴, MA Li-min³, CHEN Shao-chu¹, ZHOU Jian-hua¹, GUAN Xin-min¹, ZHANG Xian¹, LU Xue-you¹

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文章历史 +

摘要

目的　通过评价新型3D打印的导板在手术中植入颈椎椎弓根螺钉的有效性，旨在为颈椎内固定器械操作提供准确和安全的方法。方法　6例无病损成人颈椎标本，CT扫描后重建颈椎的三维数字化模型，根据颈椎椎板的具体的解剖形态特征，设计与颈椎椎板的特异性反向模板，3D 打印出颈椎的导航模块，保证进钉通道的方向和深度。采用个体化的3D导板技术， 6例标本植入84枚钉，X线片和CT图像评价术前设计的椎弓根钉进入的长度和宽度与术后实际符合程度。结果　通过数字化技术打印的个体化3D导板与颈椎椎板吻合程度高度一致，可以控制植入螺钉方向和长度。采用此导板植入的84枚螺钉中，79枚螺钉位于椎体内，5例穿破椎弓根外出骨皮质，无椎板周围重要解剖结构损伤，椎弓根钉进入的长度符合率达到100%，椎弓根钉进入的宽度符合率达到94.05%。结论新型3D打印导板使颈椎椎弓根植入的长度和宽度均达到良好的可控性，并且提高了颈椎椎弓根植入的安全性和准确率。

Abstract

Objectives　To establish a new individual-oriented template for cervical pedicle screw placement by 3D printing technology, in order to provide an accurate and safe method for cervical internal fixation operation.　Methods　6 cases of adult cervical specimens, and 64-slice spiral CT scanning data was adopted. The 3D digital models of cervical were reconstructed based on the anatomical characteristics of the cervical vertebral lamina. The reverse templates were designed, which reflected accurately morphological features of the posterior cervical spine elements. The navigation modules were obtained with the method of 3D printing, and the direction and depth of screw channel in the operation were ensured. Using 3D printing navigation templates, 24 cervical pedicle screws were inserted. Postoperative CT scan was used to measure the length of each pedicle screw channel and the width of pedicle in order to evaluate the relationship between cervical pedicle and screw position.　Results　The individual 3D printing navigation templates can exactly fuse with the cervical vertebral lamina. Postoperative CT data can confirm that 84 screws are placed entirely within the pedicle. The actual length of pedicle screw insertion was 100%, and the width of pedicle screw insertion was up to 94.05%.　Conclusion　The new 3D printing navigation template of cervical pedicle screw insertion is safe and convenient during the internal fixation operation, and the accuracy of cervical pedicle screw implantation can be improved.

导出引用

张昊,胡亚威,刘阳,王建华,李学仕,马立敏,周建华,菅新民,陈少初,张弦,卢学有. 颈椎弓根置钉植入的新型3D打印导板有效性研究[J]. 中国临床解剖学杂志. 2017, 35(2): 147-150 https://doi.org/10.13418/j.issn.1001-165x.2017.02.006

The feasibility study of cervical pedicle screwed with new individual-oriented template by 3D printing technology[J]. Chinese Journal of Clinical Anatomy. 2017, 35(2): 147-150 https://doi.org/10.13418/j.issn.1001-165x.2017.02.006

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