3D打印在脊柱侧凸矫形中的应用初探  

Application of 3D printing in orthopedics of scoliosis

作　　者：李彦明[1] 李明[1] 张国友[1] 陈自强[1] 赵颖川[1] 倪海键[1] 白玉树[1] 

机构地区：[1]第二军医大学长海医院脊柱外科,上海200433

出　　处：《第二军医大学学报》2016年第2期231-235,共5页Academic Journal of Second Military Medical University

摘　　要：目的根据CT断层扫描数据,利用3D打印技术建立患者的脊柱实体模型,并探讨其在脊柱矫形手术中的应用。方法回顾性分析第二军医大学长海医院脊柱外科在采用3D打印技术重建病变节段脊柱前后,两组脊柱侧凸患者矫形术中置钉时间、置钉准确率、神经血管损伤发生率差异等情况。结果未使用3D打印技术组患者30例,共置入椎弓根螺钉466枚,平均置钉时间(3.1±0.5)min,置钉准确率为85.6%(399/466);使用3D打印技术组患者23例,共置入椎弓根螺钉354枚,平均置钉时间(2.1±0.4)min,置钉准确率为93.2%(330/354)。两组置钉时间和置钉准确率差异具有统计学意义(P<0.01)。所有患者术中和术后均未出现神经、血管和内脏损伤等并发症。结论与传统的未使用3D打印技术的徒手置钉技术相比,术前利用患者CT数据通过3D打印技术制作患者病变节段脊柱模型可为术者制定手术计划和置钉提供参考,可以缩短置钉时间,提高置钉准确率。Objective To establish a spine solid model of patients using 3D printing technique based on CT tomoscan data, and to apply the model in spine orthopedics. Methods The time for placing the screws, the accuracy rate of screw placement, the incidence rates of nerve and blood vessel injury were retrospectively analyzed and compared before and after 3D printing technique was employed to rebuild the diseased segmental spine in two groups. Results A total of 466 pedical screws were placed in 30 patients who were not subjected to 3D printing technique, and the mean screwing time was （3. 1 _--＋-0. 5）min, with an accuracy rate of 85. 6% （399/466）. While 354 peclical screws were placed in 23 patients who were subjected to 3D printing technique, and their mean screwing time was （2. 1±0. 4）min, with an accuracy rate of 93.2% （330/354）. Significant differences were found for both the screwing time and accuracy between the two groups （P 〈 0. 01）. No patients had complication such as injuries of the nerve, blood vessel or visceral injury during or after operation. Conclusion Compared to traditional free-hand screwing technique, preoperative 3D printing model of the diseased segmental spine can provide reference for operation planning and screwing, shortening the screwing time and improving the screwing accuracy.

关 键 词：三维打印 脊柱侧凸 矫形外科学 骨钉 

分 类 号：R681.5[医药卫生—骨科学]