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[三维打印技术在骨肿瘤手术中的应用]

[Application of three-dimensional printing technology in bone tumor surgery].

作者信息

Xu Leilei, Tian Zheng, Yunus Akbar, Wang Xiaoshuai, Chen Jiangtao, Wang Chong, Song Xinghua

机构信息

Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China.

Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1069-1072. doi: 10.7507/1002-1892.201703088.

Abstract

OBJECTIVE

To discuss the effect of three-dimensional (3D) printing individualized model and guide plate in bone tumor surgery.

METHODS

Between October 2015 and December 2016, 3D printing individualized model and guide plate for making preoperative surgical planning and intraoperative treatment were used in 5 patients of bone tumor. All the patients were male, with a median age of 32 years (range, 9-58 years). There were 1 case of cystic echinococcosis at left pelvis and pathological fracture of the proximal femur; 1 case of left iliac bone osteoblastoma associated with aneurysmal bone cyst; 1 case of fibrous dysplasia of the left femur (sheep horn deformity) with pathological fracture; 1 case of metastatic carcinoma of right calcaneus (tumor staging was T N M ); and 1 case of Ewing sarcoma of left femur (tumor staging was T N M ). The disease duration ranged from 1 month to 10 years (mean, 2.25 years).

RESULTS

The operation was completed successfully. The operation time was 2.6-7.5 hours (mean, 4.9 hours). The intraoperative blood loss was 200-2 500 mL (mean, 1 380 mL). The intraoperative fluoroscopy times was 1-6 times (mean, 3.8 times). There was no infection after operation, and the blood supply and nerve function were good. All the patients were followed up 3-16 months (mean, 5.4 months). No loosening or breaking of the internal fixator occurred. According to Enneking scoring system, the limb function score was 15-26 (mean, 21); and the results were excellent in 2 cases, good in 2 cases, and fair in 1 case.

CONCLUSION

3D printing technology can make the implementation of the better preoperative planning and evaluation in bone tumor surgery, and it provides a new reference for individualized treatment in patients with bone tumor.

摘要

目的

探讨三维(3D)打印个体化模型及导板在骨肿瘤手术中的应用效果。

方法

2015年10月至2016年12月,对5例骨肿瘤患者采用3D打印个体化模型及导板进行术前手术规划及术中治疗。所有患者均为男性,年龄中位数为32岁(范围9 - 58岁)。其中左骨盆囊性棘球蚴病合并股骨近端病理性骨折1例;左髂骨骨母细胞瘤合并动脉瘤样骨囊肿1例;左股骨纤维发育不良(羊角畸形)合并病理性骨折1例;右跟骨转移癌(肿瘤分期为T N M)1例;左股骨尤因肉瘤(肿瘤分期为T N M)1例。病程1个月至10年(平均2.25年)。

结果

手术均顺利完成。手术时间为2.6 - 7.5小时(平均4.9小时)。术中出血量为200 - 2 500毫升(平均1 380毫升)。术中透视次数为1 - 6次(平均3.8次)。术后无感染,血供及神经功能良好。所有患者均获随访3 - 16个月(平均5.4个月)。内固定物无松动或断裂。根据Enneking评分系统,肢体功能评分为15 - 26分(平均21分);结果为优2例,良2例,可1例。

结论

3D打印技术可使骨肿瘤手术更好地实施术前规划及评估,为骨肿瘤患者个体化治疗提供了新的参考。

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