三维打印成型导航模板辅助枢椎椎板螺钉置入的实验研究  

A cadaveric study on establishing individualized navigation templates for axis laminar screw insertion by using a three-dimensional printing forming technique

作　　者：黄轩[1] 李凤宁[1] 张帆[1] 王琨[1] 陈智[1] 阳青松 党瑞山 杨学东 沈洪兴[1] 李明[1] 

机构地区：[1]第二军医大学长海医院骨科,上海市200081 [2]影像科,上海市200081 [3]解剖学教研室,上海市200433 [4]解放军第四一一医院影像科,上海市200081

出　　处：《中国脊柱脊髓杂志》2014年第4期366-371,共6页Chinese Journal of Spine and Spinal Cord

基　　金：国家自然科学基金资助项目(编号:81372012);长海医院“1255”学科建设计划资助项目(编号:CH125540200,CH125520900)

摘　　要：目的:探讨基于三维打印成型技术制备个体化枢椎椎板螺钉导航模板的可行性,并对该方法辅助置钉的准确性进行评估。方法:选取19具成人尸体的正常颈椎标本,行CT扫描后将原始数据导入Mimics软件,对枢椎行选择性重建,设计与枢椎椎板背侧贴合的阴模,利用三维打印技术成型,基于枢椎模型直视下徒手将阴模制成带钉道的导航模板,并在其辅助下于枢椎标本置入双侧椎板螺钉。术后再次行CT扫描评估螺钉位置。结果:基于CT图像,使用Mimics软件能够精确重建枢椎,并建立其对应阴模。共制作19个导航模板,辅助置入枢椎椎板螺钉38枚。术后CT扫描图像显示38枚螺钉均完全位于枢椎椎板内,无穿破椎板壁或进入横突孔的螺钉。结论:利用三维打印模型设计的个体化导航模板辅助置钉准确性高、操作简单,为枢椎椎板螺钉的精确置入提供了一种可供选择的新方法。Objectives： To investigate the feasibility of establishing individualized navigation templates for axis laminar screw insertion by using a three-dimensional printing forming technique, and to evaluate the accuracy of template-assisted laminar screw insertion. Methods： Nineteen adult cervical specimens were selected to take CT-scan. After original Dicom data were imported into the Mimics software, the axis model was established to generate the cavity model based on a three-dimensional printing forming technique. After using a free-hand procedure to create a navigation template with a well-established laminar screw path, bilateral laminar screws were inserted assisted by the navigation templates. CT-scan was taken postoperatively to access the position of the screws. Results： Establishing axis and the related cavity models based on CT-scan images proved to be a feasible and precise method. Thirty-eight laminar screws were implanted assisted by 19 navigation templates. CT-scan images indicated all the screws were completely contained within the laminae. No screw perforated laminar walls or transverse foramen. Conclusions： Axis laminar screw insertion assisted by a three-dimensional printing model is highly accurate and simple which can be a new alternative to conventional technique.

关 键 词：椎板螺钉 个体化导航模板 三维打印 光固化成型 熔融沉积快速成型 聚乳酸 

分 类 号：R687.3[医药卫生—骨科学]