3D打印导航模板在下颈椎骨折并脱位手术中的应用  

3D printing navigation template in the use of low cervical fracture and dislocation

作　　者：朱崇涛 范泉水[2] 冯子良[2] 陆声[3] ZHU Chong-tao;FAN Quan-shui;FENG Zi-liang;LU Sheng(Laser Medical Center,the First People′s Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology, Kumming,Yunnan 650032,China;Orthopaedics Research Institute of Kunming General Hospital,Chengdu Military Region,Kunming,Yunnan 650032,China)

机构地区：[1]云南省第一人民医院昆明理工大学附属医院激光医学中心,云南昆明650032 [2]成都军区疾病预防控制中心博士后科研工作站,云南昆明650118 [3]成都军区昆明总医院全军创伤骨科研究所,云南昆明650032

出　　处：《临床骨科杂志》2019年第2期136-139,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81171428);云南省科技计划重点项目(编号:2014FA049);成都军区医学科学技术研究项目(编号:C12048);云南省出生缺陷和遗传病研究重点实验室开放课题(编号:2017ZDKFKT005)

摘　　要：目的探讨3D打印导航模板应用于下颈椎骨折并脱位手术中椎弓根螺钉置入的准确性和安全性。方法将24例下颈椎骨折并脱位患者的C_(3～7)节段CT连续扫描的影像数据导入三维重建软件Mimics 10. 01中建立三维模型,以STL格式导出。在UG Imageware 12. 0平台打开三维重建模型。在逆向工程中将模板与椎弓根钉道拟合。术后根据颈椎X线片和CT扫描评估椎弓根螺钉位置。结果用3D打印导航模板为24例患者共置入螺钉122枚,术中导航模板与暴露的后部结构能够紧密贴合,稳定性好。所有椎弓根螺钉置入顺利,术中和术后未出现血管和神经并发症。结论 3D打印导航模板辅助下手术治疗下颈椎骨折并脱位,椎弓根螺钉置钉准确性高,操作简单,手术安全。Objective To investigate the accuracy and safety of the low cervical fracture and dislocation of pedicle screw placement in the help of the 3D printing navigation template. Methods 3D reconstruction image model of 24 C 3~7 patients suffered from traumatic fracture and dislocation were established and exported out with the STL format by software Mimics 10.01. Opened the 3D reconstruction model in the platform of UG Imageware 12.0 to fit the templates and peicle screw trajectory in reverse engineering software geomagic. After surgery, according to the cervical X-ray and CT film,the pedicle screws position were assessed. Results There were 122 pedicle screws placed in 24 patients with the help of 3D printing navigation template. Navigation template and exposed back structure could fit closely with good stability and all pedicle screws were inserted smoothly in all cases. Neither blood complication nor nerves complication were found in all cases through or after surgery. Conclusions With the help of 3D printing navigation template, the accuracy of pedicle screws placement in the operations of low cervical fracture and dislocation can be improved, which make the operations simpler and safer.

关 键 词：3D打印 快速成形模板 椎弓根螺钉置入 颈椎骨折并脱位 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]