3D打印技术用于腰椎椎弓根螺钉植入术的可行性分析

发布时间：2018-11-03 12:16

【摘要】：目的探讨3D打印技术指导腰椎椎弓根螺钉植入术的可行性。方法提取40例健康人腰椎(L1~5)薄层CT扫描数据,在椎弓根中心设计导航,获得导航模块。通过3D打印技术打印出导航模块和腰椎模型,在导航模块辅助下植入腰椎椎弓根螺钉,观察植入螺钉的进钉点、进钉方向及螺钉在椎弓根内的位置,明确椎弓根皮质是否破坏。在导航模块辅助下,于成人腰椎(尸体)标本上实施腰椎椎弓根螺钉植入,评价置钉效果。结果 3D打印腰椎模型及成人腰椎标本应用导航模块均进行98次(置钉98枚)置钉实验,其中L1均为18枚、L2均为22枚、L3均为21枚、L4均为19枚、L5均为18枚,虚拟钉道长度与实际钉道长度比较差异均无统计学意义(P均0.05)。全部螺钉的进钉点、进钉方向及螺钉于椎弓根内的位置均与方案中预见的钉道相符合,均未损伤椎弓根旁其余结构。结论 3D打印腰椎导航模块可指导腰椎螺钉植入,植入的螺钉在进钉点、进钉方向及固定位置等方面均无偏差。
[Abstract]:Objective to explore the feasibility of 3 D printing technique for lumbar pedicle screw implantation. Methods the thin layer CT scanning data of lumbar vertebrae (L _ 1 / 5) were extracted from 40 healthy subjects and the navigation module was designed at the center of pedicle. The navigation module and lumbar vertebrae model were printed out by 3D printing technique. The pedicle screw was implanted in the aid of navigation module. The point of screw entry, the direction of screw entry and the position of screw in pedicle were observed to determine whether the pedicle cortex was damaged or not. With the aid of navigation module, pedicle screw implantation was performed on adult lumbar vertebrae (cadaveric body) to evaluate the effect of screw placement. Results 98 nailing experiments were carried out in 3D printed lumbar vertebrae model and adult lumbar vertebrae with navigation module. Among them, 18 were L1, 22 L2, 21 L3, 19 L4, 18 L5, 18 L3, 19 L4, 18 L5, 22 L2, 21 L3, 19 L4, 18 L5, 18 L5, 22 L2, 21 L3, 19 L4 and 18 L5 respectively. There was no significant difference in the length of the virtual and actual snails between the two groups (P 0.05). The point of screw entry, the direction of screw entry and the position of the screw in the pedicle of the pedicle were consistent with those predicted in the scheme, and the other structures around the pedicle were not damaged. Conclusion 3D printing of lumbar spine navigation module can guide lumbar screw implantation, and there is no deviation in the point of insertion, the direction of screw entry and the fixed position of the implanted screw.
【作者单位】：承德医学院附属医院;
【基金】：承德市科学技术研究与发展计划项目(20157060)
【分类号】：R687.3

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