定制高位颈椎固定患者指南的研发。
Development of a Patient-specific Guide for High Cervical Spine Fixation.
作者信息
Nanni Felipe de Negreiros, Vialle Emiliano Neves, Foggiattob José Aguiomar, Silva Kayo Winiccius Samuel Neves E, Mello Neto Heraldo de Oliveira
机构信息
Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
Núcleo de Prototipagem Ferramental, Departamento de Mecânica, Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brasil.
出版信息
Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):20-25. doi: 10.1016/j.rbo.2017.09.011. Epub 2019 Mar 1.
OBJECTIVE
High cervical spine fixation represents a challenge for spine surgeons due to the complex anatomy and the risks of vascular and medullar injury. The recent advances in 3-D printing have unfolded a whole new range of options for these surgeons.
METHODS
In the present study, a guide for the placement of the lateral mass screw in the C1 vertebra was developed using 3-D printing. Eight real-size models of the high cervical spine and their respective screw guides were built using computed tomography (CT) scan images. The guidewires were inserted with the help of the printed guides and then the models were analyzed with the help of CT scan images.
RESULTS
All of the guidewires in the present study obtained a safe placement in the models, avoiding the superior and inferior articular surfaces, the vertebral foramen, and the vertebral artery.
CONCLUSION
The present study demonstrated the efficiency of the guide, a reliable tool for aiding the insertion of guidewires for screws in lateral masses of the C1.
目的
由于解剖结构复杂以及存在血管和脊髓损伤风险，高位颈椎固定对脊柱外科医生而言是一项挑战。3D打印技术的最新进展为这些外科医生带来了全新的选择。
方法
在本研究中，利用3D打印技术制作了用于C1椎体侧块螺钉置入的导向器。使用计算机断层扫描（CT）图像构建了8个真实尺寸的高位颈椎模型及其各自的螺钉导向器。借助打印的导向器插入导丝，然后借助CT图像对模型进行分析。
结果
本研究中的所有导丝在模型中均实现了安全置入，避开了上下关节面、椎孔和椎动脉。
结论
本研究证明了该导向器的有效性，它是辅助在C1侧块中插入螺钉导丝的可靠工具。
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