个体化3D打印导板在寰枢椎椎弓根置钉中的初步应用  

Preliminary application of individualized 3D printing template for C1-C2 pedicle screw implantation

作　　者：周全[1] 赵加力[1] 张少先[1] 徐进[1] 潘伟[1] 王新宏[1] 张佳园 

机构地区：[1]江苏省淮安市第二人民医院脊柱外科,223002

出　　处：《临床外科杂志》2017年第8期586-588,共3页Journal of Clinical Surgery

基　　金：江苏省"六大人才高峰"基金资助项目(WSW-159)

摘　　要：目的评估个体化3D打印导板辅助寰枢椎椎弓根螺钉技术在临床应用中的安全性及准确性。方法枢椎齿状突Ⅱ型骨折行后路椎弓根螺钉内固定术病人3例,根据寰枢椎后方骨性结构数据设计个体化导板,术中根据导板确定进针点,磨钻磨除进针点骨皮质,根据导板方向建立钉道,根据术前测量选择并拧入合适长度螺钉。术后通过观察螺钉在CT横断面和矢状面的位置来评估螺钉置入的安全性。结果术后CT检查显示共置入寰椎椎弓根螺钉6枚,枢椎椎弓根螺钉6枚,12枚螺钉均为0级螺钉。结论个体化3D打印导板能辅助寰枢椎椎弓根螺钉置钉技术,提高临床手术置钉的准确率和安全性,减少神经血管损伤。Objective To evaluate the safety and accuracy of individualized 3D printing template for C1-C2 pedicle screw technique. Methods 3 patients undergoing C1-C2 pedicle screw fixation because of odontoid fracture type Ⅱ. We designed individualized 3D printing template according to the bony structure data,then we determined the insertion point according to the template,and removed the cortex of insertion point with a reamer. We builded screw channels according to the direction and implanted pedicle screw. After the surgery,we evaluated the safety and accurate by CT scan. Results 6 atlas pedicle screws and 6 axis pedicle screws were implanted,and all screws were classified as class 0. Conclusion Individualized 3D printing template can assist and improve the accuracy and safety of C1-C2 pedicle screw implantation,decrease the injury to nerve and vessel.

关 键 词：3D打印 颈椎 椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]