3D打印辅助术前规划在经皮椎体成形术中的应用  

Application of 3D printing assisted preoperative planning in percutaneous vertebroplasty

作　　者：史玉林[1] 王炳武[1] 刘伟强[1] 于明东[1] 杨国誉 袁鹏[2] 孙泽豪 SHI Yulin;WANG Bingwu;LIU Weiqiang;YU Mingdong;YANG Guoyu;YUAN Peng;SUN Zehao(Department of Spine Orthopaedics,Weifang People's Hospital,Weifang 261041,China;Surgery Department of Weifang Medical University)

机构地区：[1]潍坊市人民医院脊柱外科,山东潍坊261041 [2]潍坊医学院外科学教研室

出　　处：《潍坊医学院学报》2018年第5期378-380,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市科技发展计划(课题编号:2015WS025;2016YX002)

摘　　要：目的探讨3D打印在经皮椎体成形术(PVP)的应用。方法回顾性总结2016年2月～2018年6月于潍坊市人民医院脊柱外科二区住院治疗的骨质疏松胸腰椎骨折的病例,骨折椎体均位于T8～L3,其中行3D打印骨折椎体辅助PVP组:20例,术前患者在胸部垫高俯卧位行薄层CT扫描,构建三维数字模型,由影像科医师将其DICOM数据输入计算机中采用Mimics软件进行处理,然后将数据按1∶1比例打印伤椎的骨折模型,于术前行穿刺点、进针长度、角度等设计;选取同时期同节段传统PVP组:20例对照。对两组患者手术时间、注入骨水泥前射线暴露次数等因素进行统计分析。结果所有患者均顺利完成手术。3D打印辅助PVP组穿刺定位时间和射线暴露次数明显少于传统PVP组,差异有统计学意义(P <0. 01)。3D打印辅助PVP组和传统PVP组患者的VAS评分明显改善,术前、术后两组间差异无统计学意义。结论术前利用3D打印伤椎进行PVP术前规划效果良好,可明显缩短手术时间及透视次数,有重要的临床应用价值。Objective To investigate the application of 3D printing in percutaneous vertebroplasty.Methods A retrospective review of osteoporotic thoracolumbar fractures treated in the second district of the department of spinal surgery of weifang people's hospital from February 2016to June 2018.The fractured vertebral bodies were located at T8 L3,including 3D printing.Fracture vertebral body assisted PVP group :20patients.Preoperative patients underwent thinslice CT scan in the prone position of the chest,constructing a three-dimensional digital model,and the DICOM data was input into the computer by the imaging physician using Mimics software,and then the data was processed.The fracture model of the injured vertebrae was printed in a 1:1 ratio,and the design of the puncture point,the length of the needle, and the angle before the operation was performed.The traditional PVP group at the same stage was selected:20cases were compared.Statistical analysis was performed on factors such as the operation time of the two groups of patients and the number of ray exposures before bone cement injection.Results All patients completed the procedure successfully. The puncture positioning time and the number of radiation exposures in the 3D print-assisted PVP group were significantly lower than those in the traditional PVP group,and the difference was statistically significant(P <0.01).The VAS scores of the 3D print-assisted PVP group and the traditional PVP group were significantly improved,and the difference between the two groups before and after surgery was not significant.Conclusion The preoperative planning of PVP using 3D printed injured vertebrae is good,which can shorten the operation time and the number of fluoroscopy,and has important clinical application value.

关 键 词：3D打印 骨质疏松 病理性骨折 经皮椎体成形术 

分 类 号：R681.5[医药卫生—骨科学]