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| 基于三维打印成型技术制备个体化椎弓根置钉导航模板的动物实验研究 |
| 黄轩1△,王毅峰1,2△,李凤宁1,张帆1,王琨1,陈智1,阳青松3,沈洪兴1*,李明1 |
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(1. 第二军医大学长海医院骨科, 上海 200433;
2. 厦门警备区医院, 厦门 361000;
3. 第二军医大学长海医院影像科, 上海 200433
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 探讨一种基于三维打印成型技术制备个体化椎弓根置钉导航模板的可行性，并对该方法辅助置钉的准确性进行评估。方法 选取5只雄性崇明山羊，将全脊柱CT扫描数据导入Mimics® 软件，重建C3~6、T3~6和L3~6节段，设计与椎体后部贴合的阴模，利用三维打印技术成型，基于椎体模型直视下徒手将阴模制成带钉道的导航模板，并在其辅助下于目标椎体置入双侧椎弓根螺钉。术后再次行CT扫描评估螺钉位置。结果 共制作60个导航模板，辅助置入椎弓根螺钉119枚，1枚螺钉因椎弓根发育异常而放弃置钉。CT扫描轴位图像显示114枚螺钉完全位于椎弓根内，5枚部分穿破椎弓根壁；矢状位图像提示除2枚螺钉突破椎间孔外，余钉位准确。结论 基于CT图像，使用Mimics® 软件能够精确重建并建立椎体及其对应阴模。利用三维打印模型所设计的个体化导航模板，辅助置钉准确性高，操作简单，为脊柱后路的精确置钉提供了一种可供选择的新方法。 |
| 关键词: 三维打印 椎弓根螺钉 Mimics®软件 个体化导航模板 聚乳酸 |
| DOI：10.3724/SP.J.1008.2014.00992 |
| 投稿时间：2014-01-23修订日期：2014-03-20 |
| 基金项目:国家自然科学基金（81372012），长海医院“1255” 学科建设计划项目（CH125540200，CH125520900）. |
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| Preparation of individualized navigation templates for pedicle screw insertion in goats using a three-dimensional printing forming technique |
| HUANG Xuan1△,WANG Yi-feng1,2△,LI Feng-ning1,ZHANG Fan1,WANG Kun1,CHEN Zhi1,YANG Qing-song3,SHEN Hong-xing1*,LI Ming1 |
(1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Hospital of Xiamen Garrison Command, Xiamen 361000, Fujian, China;
3. Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors.
* Corresponding author.) |
| Abstract: |
| Objective To investigate the feasibility of preparing individualized navigation templates for pedicle screw insertion using a three-dimensional printing forming technique, and to evaluate the accuracy of template-assisted pedicle screw insertion. Methods Five male Chongming goats were selected and total spine CT-scan was performed. After the original Dicom data were imported into the Mimics® software, the C3-6, T3-6 and L3-6 spinal column models were created to design and generate the cavity models based on a three-dimensional printing forming technique. The navigation template was created with a well-established pedicle screw path using a free-hand procedure, and then bilateral pedicle screw insertion was done assisted by the navigation templates. CT-scan was taken again postoperatively to access the position of the screws. Results Totally 60 navigation templates were prepared and 119 pedicle screws were implanted under the assistance of these templates, with one pedicle screw insertion failed due to a congenital deformity. CT-scan axial images indicated that 114 pedicle screws were completely contained within the pedicles, while 5 screws perforating the pedicle walls. Sagittal images showed accurate screw placement except for 2 screws perforating into the foramen. Conclusion The present study indicates that Mimics® software is a feasible and precise method for establishing spinal column and related cavity model based on CT-scan images. Pedicle screw insertion assisted by a three-dimensional printing model is highly accurate and easy to perform, which may be a new alternative to conventional technique. |
| Key words: three-dimensional printing pedicle screw Mimics® software individualized navigation templates polylactic acid |
