基于3D打印技术的个体化仿生型人工椎板的实验研究  

Experimental Study of Individualized Bionic Artificial Lamina Based on 3D Printing Technique

作　　者：黎建文[1] 黎松波[1] 刘先银[1] 何仲佳[1] 方冠军[1] 陈耀鑫[1] 刘志伟[1] 卢健锋 叶国标[1] 尹煜超 LI Jian-wen;LI Song-bo;LIU Xian-yin(Department of Spinal Surgery,Dongguan People's Hospital,Dongguan 523069,China)

机构地区：[1]东莞市人民医院脊柱外科,广东东莞523069

出　　处：《医学临床研究》2020年第3期336-339,342,共5页Journal of Clinical Research

基　　金：东莞市社会科技发展重点项目(编号:201750715001441)。

摘　　要：【目的】探讨3D打印技术制作出钛合金个体化仿生型人工椎板应用于腰椎椎板切除术后脊柱重建的可行性。【方法】选取1具成人腰椎的尸体标本,3D打印出钦合金仿生型人工椎板,行腰椎椎板切除和人工椎板植入手术,采用皮质骨轨迹锁定螺钉固定,观察其稳定性,术后行CT扫描了解人工椎板和螺钉的情况。【结果】本研究设计的仿生脊柱椎板形态与原椎板结构相似,模拟手术中易于安装,匹配性好,利用皮质骨轨迹螺钉技术固定仿生椎板稳定性好,保留的棘上、棘间初带能重建到人工椎板棘突的缝合孔上;CT扫描结果显示设计的人工椎板与原脊柱棘突椎板结构相似,匹配性好,固定螺钉位置理想,骨性椎管容积和前后径较术前明显增加。【结论】应用3D打印技术设计的个体化仿生型人工椎板应用于腰椎椎板切除术后的重建,可增加椎管容积,且匹配性和稳定性好,具有保留脊柱节段的活动度和提供后方韧带附着点重建的优点。【Objective】The individualized bionic artificial lamina of titanium alloy was made by 3D printing technique.The feasibility of implantation was discussed through the model of lumbar laminectomy.【Methods】A sample of adult lumbar vertebrae was selected,and the titanium alloy bionic artificial plate was printed in 3D.The lumbar vertebral laminectomy and implantation were performed and the cortical bone trajectory screw and locking screw technique were used to fix it.Afterwards the stability was observed.Finally,CT scan was applied to understand the condition of artificial lamina and screw s.【Results】The morphology of bionic spinal lamina designed in this study was similar to the original lamina structure.It was easy to install and matched well in simulated surgery.The use of cortical bone trajectory screw technique to fix the bionic lamina showed good stability.The retained spine and interspinous ligaments were reconstructed to the suture hole of artificial lamina spinous process.The results of CT scan showed that the designed artificial lamina was similar to the original spinal spinous process lamina,with good matching,ideal position of fixation screw and significant increase in the volume and anteroposterior diameter of osseous spinal canal after surgery.【Conclusion】The individualized bionic artificial lamina designed by 3D printing technique can increase the volume of spinal canal after lumbar laminectomy,whose compatibility and stability are good.It has the advantages of retaining the motion of spinal segment and providing posterior ligament attachment point reconstruction.

关 键 词：成像 三维 人工椎板 

分 类 号：R687.37[医药卫生—骨科学]