| 摘要: |
| 目的 探讨3D打印技术制备个体化颈椎间融合器(Cage)的可行性并验证其终板匹配性. 方法 选取经甲醛浸泡的成人新鲜尸体标本10具,男女各5具.截取标本的C1~C7节段,行CT平扫并将平扫图像导入Mimics软件,制作个体化C5/6椎间融合器模型,通过3D打印机打印出椎间融合器.对每具标本施行C5/6椎间隙减压植骨术后再次行CT检查,通过打印椎间融合器与上下终板间的间隙来评价终板匹配性(间距< 1 mm,匹配性优;1 mm≤间距< 2 mm,匹配性良;间距≥2 mm,匹配性差),每个椎间融合器测量36个点. 结果 大体观察发现椎间融合器与椎间隙嵌合度较好,融合器植入后稳定性较好,无融合器过大不能置入发生,无融合器松动脱落.6例标本(6/10)所有测量点匹配性均为优;3例标本(3/10)中14个点(3.89%)匹配性良,其中1例6个点、另2例各4个点匹配性良;1例标本(1/10)中共3个点(0.83%)匹配性差;共计343个点(343/360,95.28%)匹配性优. 结论 Mimics软件可很好呈现颈椎椎体和椎间隙解剖结构,并可据此进行颈椎Cage的个体化设计;利用3D打印可实现颈椎Cage产品快速成型,且打印产品与宿主终板匹配满意. |
| 关键词: 颈椎 脊柱融合术 椎间融合器 三维打印 |
| DOI：10.3724/SP.J.1008.2015.00782 |
| 投稿时间：2014-11-21修订日期：2015-04-28 |
| 基金项目:第二军医大学长海医院"1255" 学科建设计划(CH125540200, CH125520900). |
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| Three-dimensional printing for fabricating individualized endplate matching cervical cage |
| ZHANG Fan,HUANG Xuan,LI Feng-ning,SONG Qing-xin,WANG Yi-feng,SHEN Hong-xing* |
(Department of Spinal Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the feasibility of fabricating individualized cervical cage by three-dimensional printing and to verify the endplate matching of cage. Methods Ten fresh adult cervical specimens (5 males and 5 females, C1-C7) were subjected to CT-scan. The original Dicom data were fed into the Mimics software to create the fifth and sixth cervical vertebra and disc model, which was used to prepare individualized cervical cage using three-dimensional printing technique. All the specimens received anterior cervical discectomy and fusion in C5/6 disc, and CT-scan was taken postoperatively to access the endplate matching of cage. The matching degree was accessed at 36 points in each cage; excellent matching was defined as the distance between endplate and cage being less than 1 mm, good as the distance being greater than or equal to 1 mm while less than 2 mm, and poor as the distance being greater than or equal to 2 mm. Results Gross observation found that the cage well fit the veterbral disc, with satisfactory stability, with no cage being too large for implanting into the veterbral disc or cage drop-out. Six (60%) specimens had excellent matching on all the 36 points. Three specimens had 14 (3.89%) points matched good, including one with 6 points and two with 4 points each; the last specimen had 3 (0.83%) points matched poor. A total of 343 points (95.28%) had excellent matching in the present study. Conclusion Mimics software can well present the anatomical structures of cervical vertebral body and intervertebral disc, enabling individualized design of cervical cage. Three-dimensional printing can achieve rapid prototyping of individualized cage, which can well match the host endplate. |
| Key words: cervical vertebrae spinal fusion cage 3D printing |
