Coote Jeffrey D, Nguyen Theresa, Tholen Kaitlyn, Stewart Caleb, Verter Elizabeth, McGee John, Celestre Paul, Sarkar Korak
The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Tulane University School of Science and Engineering, New Orleans, LA.
Ochsner J. 2019 Spring;19(1):49-53. doi: 10.31486/toj.18.0117.
Pediatric spinal deformity surgeries are challenging operations that require considerable expertise and resources. The unique anatomy and rarity of these cases present challenges in surgical training and preparation. We present a case series illustrating how 3-dimensional (3-D) printed models were used in preoperative planning for 3 cases of pediatric spinal deformity surgery. Patient 1 was a 6-year-old male with scoliosis secondary to an L3 hemivertebra and severe congenital heart disease who underwent excision of the L3 hemivertebra and L2-L4 spinal fusion. Patient 2 was an 11-year-old male with an L2 hemivertebra and lumbar kyphosis who underwent excision of the L2 hemivertebra and T12-L4 spinal fusion. Patient 3 was a 6-year-old female with Down syndrome who presented with atlantoaxial instability and acute lymphoblastic leukemia. She underwent occipital-cervical spinal fusion and decompression. Prior to surgery, 3-D printed models of the patients' spines were created based on computed tomography (CT) imaging. The anatomic complexity and risk of devastating neurologic consequences in spine surgery call for careful preparations. 3-D models enable more efficient and precise surgical planning compared to the use of 2-dimensional CT/magnetic resonance images. The 3-D models also make it easier to visualize patient anatomy, allowing patients and their families who lack medical training to interpret and understand cross-sectional anatomy, which in our experience, enhanced the consultations.
小儿脊柱畸形手术是具有挑战性的手术，需要相当多的专业知识和资源。这些病例独特的解剖结构和罕见性给手术培训和准备工作带来了挑战。我们展示了一个病例系列，说明三维（3-D）打印模型如何用于3例小儿脊柱畸形手术的术前规划。患者1是一名6岁男性，因L3半椎体和严重先天性心脏病继发脊柱侧弯，接受了L3半椎体切除和L2-L4脊柱融合术。患者2是一名11岁男性，患有L2半椎体和腰椎后凸畸形，接受了L2半椎体切除和T12-L4脊柱融合术。患者3是一名6岁患有唐氏综合征的女性，伴有寰枢椎不稳和急性淋巴细胞白血病。她接受了枕颈脊柱融合术和减压术。手术前，根据计算机断层扫描（CT）成像创建了患者脊柱的3-D打印模型。脊柱手术中解剖结构的复杂性和严重神经损伤后果的风险需要仔细准备。与使用二维CT/磁共振图像相比，3-D模型能实现更高效、精确的手术规划。3-D模型还使患者解剖结构更容易可视化，让缺乏医学培训的患者及其家属能够解读和理解横断面解剖结构，根据我们的经验，这加强了会诊效果。
