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用于颈胸段后凸前路融合的肋骨支撑移植的三维全尺寸氯化钠模型的效用

Utility of a 3-dimensional full-scale NaCl model for rib strut grafting for anterior fusion for cervicothoracic kyphosis.

作者信息

Kobayashi Kazuyoshi, Imagama Shiro, Muramoto Akio, Ito Zenya, Ando Kei, Yagi Hideki, Hida Tetsuro, Ito Kenyu, Ishikawa Yoshimoto, Tsushima Mikito, Ishiguro Naoki

机构信息

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Orthopaedic Surgery, Kariya Toyota General Hospital, Kariya, Japan.

出版信息

Nagoya J Med Sci. 2015 Aug;77(3):525-30.

Abstract

In severe spinal deformity, pain and neurological disorder may be caused by spinal cord compression. Surgery for spinal reconstruction is desirable, but may be difficult in a case with severe deformity. Here, we show the utility of a 3D NaCl (salt) model in preoperative planning of anterior reconstruction using a rib strut in a 49-year-old male patient with cervicothoracic degenerative spondylosis. We performed surgery in two stages: a posterior approach with decompression and posterior instrumentation with a pedicle screw; followed by a second operation using an anterior approach, for which we created a 3D NaCl model including the cervicothoracic lesion, spinal deformity, and ribs for anterior reconstruction. The 3D NaCl model was easily scraped compared with a conventional plaster model and was useful for planning of resection and identification of a suitable rib for grafting in a preoperative simulation. Surgery was performed successfully with reference to the 3D NaCl model. We conclude that preoperative simulation with a 3D NaCl model contributes to performance of anterior reconstruction using a rib strut in a case of cervicothoracic deformity.

摘要

在严重脊柱畸形中,脊髓受压可能导致疼痛和神经功能障碍。脊柱重建手术是可取的,但在严重畸形的情况下可能会很困难。在此,我们展示了三维氯化钠(盐)模型在一名49岁患有颈胸段退变性脊柱侧凸男性患者前路重建术前规划中的应用,该重建使用肋骨支撑物。我们分两个阶段进行手术:后路减压和椎弓根螺钉后路内固定;随后进行第二次手术,采用前路入路,为此我们创建了一个三维氯化钠模型,包括颈胸段病变、脊柱畸形和用于前路重建的肋骨。与传统石膏模型相比,三维氯化钠模型易于刮削,并且在术前模拟中有助于规划切除范围和确定合适的移植肋骨。参照三维氯化钠模型成功实施了手术。我们得出结论,三维氯化钠模型的术前模拟有助于在颈胸段畸形病例中使用肋骨支撑物进行前路重建。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb7a/4574342/dfd53e131866/2186-3326-77-0525-g001.jpg

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