Wilcox Ben, Mobbs Ralph J, Wu Ai-Min, Phan Kevin
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia.
Faculty of Medicine, University of New South Wales (UNSW), Randwick, Sydney, Australia.
J Spine Surg. 2017 Sep;3(3):433-443. doi: 10.21037/jss.2017.09.01.
Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.
三维打印（3DP），也被称为“增材制造”，是一个快速发展的行业，尤其是在脊柱外科领域。鉴于脊柱解剖结构复杂以及周围结构的脆弱性，3DP有潜力辅助手术规划并提高手术操作的准确性。我们对当前关于3DP在脊柱外科应用的文献进行了系统综述。检索了六个电子数据库，以查找报告3DP脊柱外科手术模型、导向器或植入物的病例或结果的原始发表研究。对这些研究的结果进行了综合和总结。这些检索共返回2411篇文章。其中，54篇被纳入本综述。3DP目前用于手术规划、术中手术导向器、定制假体以及“现成”植入物。该技术有可能改善植入物性能，减少手术时间并提高患者预后。迄今为止，大多数数据来自质量较低的研究，这些研究存在与新领域热潮相关的固有偏差。随着文献数量不断增加，评估优缺点的大规模研究以及长期随访将增进我们对3DP在脊柱外科中作用的了解。此外，随着这个快速发展的领域逐渐成熟，诸如经济影响、设计和打印时间、材料选择以及生物打印等问题也将不断演变。
