Department of Orthopaedics, General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.
Eur Spine J. 2010 May;19(5):797-802. doi: 10.1007/s00586-010-1359-0. Epub 2010 Mar 7.
Surgical treatment of complex severe spinal deformity, involving a scoliosis Cobb angle of more than 90 degrees and kyphosis or vertebral and rib deformity, is challenging. Preoperative two-dimensional images resulting from plain film radiography, computed tomography (CT) and magnetic resonance imaging provide limited morphometric information. Although the three-dimensional (3D) reconstruction CT with special software can view the stereo and rotate the spinal image on the screen, it cannot show the full-scale spine and cannot directly be used on the operation table. This study was conducted to investigate the application of computer-designed polystyrene models in the treatment of complex severe spinal deformity. The study involved 16 cases of complex severe spinal deformity treated in our hospital between 1 May 2004 and 31 December 2007; the mean +/- SD preoperative scoliosis Cobb angle was 118 degrees +/- 27 degrees. The CT scanning digital imaging and communication in medicine (DICOM) data sets of the affected spinal segments were collected for 3D digital reconstruction and rapid prototyping to prepare computer-designed polystyrene models, which were applied in the treatment of these cases. The computer-designed polystyrene models allowed 3D observation and measurement of the deformities directly, which helped the surgeon to perform morphological assessment and communicate with the patient and colleagues. Furthermore, the models also guided the choice and placement of pedicle screws. Moreover, the models were used to aid in virtual surgery and guide the actual surgical procedure. The mean +/- SD postoperative scoliosis Cobb angle was 42 degrees +/- 32 degrees, and no serious complications such as spinal cord or major vascular injury occurred. The use of computer-designed polystyrene models could provide more accurate morphometric information and facilitate surgical correction of complex severe spinal deformity.
手术治疗复杂严重脊柱畸形，涉及到脊柱侧凸 Cobb 角大于 90 度和后凸或椎体和肋骨畸形，具有挑战性。术前二维图像由普通 X 线摄影、计算机断层扫描（CT）和磁共振成像提供，提供的形态计量信息有限。虽然具有特殊软件的三维（3D）重建 CT 可以在屏幕上观察到立体和旋转的脊柱图像，但它不能显示全脊柱，也不能直接在手术台上使用。本研究旨在探讨计算机设计聚苯乙烯模型在复杂严重脊柱畸形治疗中的应用。本研究纳入了 2004 年 5 月 1 日至 2007 年 12 月 31 日在我院治疗的 16 例复杂严重脊柱畸形患者；术前脊柱侧凸 Cobb 角的平均值为 118 度 +/- 27 度。收集受影响脊柱节段的 CT 扫描数字成像和通信在医学（DICOM）数据集进行 3D 数字重建和快速原型制作，以准备计算机设计的聚苯乙烯模型，这些模型应用于这些病例的治疗中。计算机设计的聚苯乙烯模型允许直接对畸形进行 3D 观察和测量，这有助于外科医生进行形态评估并与患者和同事沟通。此外，该模型还指导了椎弓根螺钉的选择和放置。此外，该模型还用于辅助虚拟手术和指导实际手术过程。术后脊柱侧凸 Cobb 角的平均值为 42 度 +/- 32 度，没有发生脊髓或大血管损伤等严重并发症。计算机设计聚苯乙烯模型的使用可以提供更准确的形态计量信息，并有助于复杂严重脊柱畸形的手术矫正。
