3D打印技术建立山羊腰椎融合模型及实验围手术期管理  

Eestablishment of the model of goat lumbar spinal fusion by 3D printing technology and experimental perioperative management

作　　者：张峰[1,2] 刘俭涛 王瑞[2] 卢腾[2] 牛斌斌 秦杰[2] 蔡璇[2] 张廷[2] 欧阳鹏荣 贺西京[2] ZHANG Feng;LIU Jian-tao;WANG Rui;LU Teng;NIU Bin-bin;QIE Jie;CAI Xuan;ZHANG Ting;OUYANG Peng-rong;HE Xi-jing(Department of Orthopaedics, the Second Affiliated Hospital of Xi＇an Jiaotong University ,Xi＇an 710004,Shannxi, China)

机构地区：[1]西安市第四医院骨科,陕西西安710004 [2]西安交通大学第二附属医院骨科,陕西西安710004

出　　处：《中国骨伤》2018年第5期458-464,共7页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金资助项目(编号:81571209)~~

摘　　要：目的:探讨个体化3D打印技术建立山羊腰椎融合模型的可行性及围手术期管理的注意事项。方法 :根据10只雄性1~2岁、体重35~45 kg波尔山羊腰椎术前X线片及CT三维重建数据,术前确定理论撑开高度,再根据理论进钉点确定钢板长度、弧度、放置位置及上下位螺钉长度等参考值,设计并进行3D打印腰椎侧前路接骨板。全麻下切除山羊腰椎椎体及相邻椎间盘,将植骨后的钛笼植入山羊体内,使用3D打印侧路接骨板进行固定。术后进行饲养、补液、抗感染及术后并发症处理、呼吸消化围手术期管理等。结果:成功建模,10只山羊术后X线片及CT三维重建显示钛笼及接骨板位置较好,固定可靠。术后3个月山羊行腰椎CT三维重建及显微CT,观察脊柱融合情况。影像学检查显示,侧路接骨板固定钛笼植骨融合均在钛笼两端与椎体间形成致密的骨小梁。结论:该3D打印技术建立山羊腰椎融合模型,是一种有效,成功率高,融合可靠稳定的方法,围手术期管理其方法科学、实用,且更加人性化,对确保腰椎侧前方钉板内固定系统成功置入,并降低手术并发症的发生具有较强的指导意义。Objective：To explore the feasibility and the attention of perioperative management of goat lumbar fusion model for individualized 3D printing technology. Methods：According to preoperative X-ray and CT three dimensional reconstruction data of 10 males Boer goat＇s lumbar（1-2 years old,weight 35-45 kg）,the preoperative open height were determined,meanwhile,according to the theoretical entry point of nails,the length of steel plate,arc,and setting position,screw length for reference were determined,the lumbar lateral anterior plate was designed and 3D-printed. Goats lied on the right side,under the general anesthesia,the lumbar vertebrae of the goats and the adjacent intervertebral disc were resected,and the titanium cage after the bone graft was implanted into the goat,the 3D-print lateral bone plate was fixed. After operation,feeding,fluid infusion,anti infection,postoperative complications management,respiratory digestion perioperative management were performed. Results：The 10 models for goats were successful in results. Postoperative X-ray film and three-dimensional reconstruction of CT showed that titanium cage and bone plate were in good position and reliable. Three months after the operation,CT 3D reconstruction and micro-CT of the goat were observed,and the fusion of the spine was observed. Imaging studies showed that the fusion of the lateral bone plate fixation titanium cage was both at the end of the titanium cage and the dense bone trabecular formation between the vertebral bodies. Conclusion：The 3D printing technology sets up the goat lumbar spinal fusion model successfully,which is a kind of effective,more successful,reliable and stable method,perioperative management.The method is scientific,practical,and more humanized,to ensure that lumbar lateral successfully implanted the nail plate of lateralanterior internal fixation system,with reduction of occurrence of surgical complications.

关 键 词：山羊 打印 三维 腰椎 脊柱融合术 围手术期医护 

分 类 号：R687.3[医药卫生—骨科学] TP391.73[医药卫生—外科学]