CT三维重建配合3D打印技术在辅助寰枢椎椎弓根螺钉置入的应用价值评估  

The application value of CT three-dimensional reconstruction combined with 3D printing technology in atlantoaxial pedicle screw placement operation

作　　者：郭飞[1] 王全鹏 代建昊 张莉[2] GUO Fei;WANG Quan-peng;DAI Jian-hao;ZHANG Li(Department of Radiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Department of Medical Imaging,Bengbu Medical College,Bengbu Anhui 233030;Department of Orthopedics,The First People＇s Hospital of Huainan,Huainan Anhui 232007,China)

机构地区：[1]蚌埠医学院第一附属医院放射科,安徽蚌埠233004 [2]蚌埠医学院影像学系,安徽蚌埠233030 [3]安徽省淮南市第一人民医院骨科,232007

出　　处：《蚌埠医学院学报》2018年第6期784-788,共5页Journal of Bengbu Medical College

基　　金：国家自然科学基金(31600862);安徽省高等学校省级自然科学研究项目(KJ2015B100by);省级大学生创新创业计划项目(201610367013);2017年蚌埠市级科技创新指导类项目(20160305)

摘　　要：目的:探讨CT三维重建配合3D打印技术在辅助寰枢椎椎弓根螺钉置入的应用价值。方法:通过CT三维重建的多种后处理技术明确寰枢椎病变13例作为观察组,再将CT三维重建、逆向工程原理及快速成形技术相结合,设计出一种新型的导航模板,辅助椎弓根螺钉置入,并与13例之前已通过X线透视置钉法的病例(对照组)进行置钉效果比较。结果:对照组13例共置椎弓根螺钉41枚,其中Ⅰ类置钉9枚,Ⅱ类置钉18枚,Ⅲ类置钉14枚,成功率65.9%;观察组共打印颈椎模型13例,设计导向模板21个,5例由于先前通过X线透视仅在枢椎两侧的椎弓根内置钉,只制作出枢椎的导航模板;模拟手术同样置钉41枚,其中Ⅰ类置钉15枚,Ⅱ类置钉21枚,Ⅲ类置钉5枚,成功率87.8%。结论:CT三维重建的各种后处理技术不仅能够准确的判断寰枢椎病变,并能配合3D打印技术,制作出个体化的导航模板,使上颈椎椎弓根螺钉的置入变得既安全又省时,并能在术后准确评估置钉效果。Objective： To investigate the application value of CT three-dimensional reconstruction combined with 3D printing technology in atlantoaxial pedicle screw placement operation. Methods： Thirteen atlantoaxial？ lesions patients diagnosed by postprocessing methods of CT three-dimensional reconstruction were set as the observation group. A kind of new navigation template guiding the atlantoaxial pedicle screw placement operation was designed through CT three-dimensional reconstruction,principle of reverse engineering and rapid prototyping technology. Thirteen patients treated with pedicle screw fixation by X-ray fluoroscopy were set as the control group. The treatment effect between two groups was compared. Results： Forty-one pedicle screws in control group were implanted,which included 9 cases of level-I,18 cases of level-II and 14 cases of level-III pedicle screws,and the success rate of which was 65. 9%. Twenty-one guiding templates were designed in observation group,and 5 cases were treated with X-ray fluoroscopy for the internal fixation of pedicle screws. Forty-one pedicle screws in simulated operation were implanted,which included 11 cases of level-Ⅰ,21 cases of level-Ⅱ and 5 cases of level-Ⅲ pedicle screws,and the success rate of which was 87. 8%. Conclusions： The postprocessing methods of CT three-dimensional reconstruction can accurately diagnose the atlantoaxial vertebral lesions,which combining with 3 D printing technology in cervical pedicle screw placement operation is safe and short time,and can accurately evaluate the effect of pedicle screw insertion after surgery.

关 键 词：寰枢椎病变 辅助椎弓根螺钉置入 CT三维重建 3D打印技术 

分 类 号：R323.4[医药卫生—人体解剖和组织胚胎学]