Bohl Michael A, McBryan Sarah, Nakaji Peter, Chang Steve W, Turner Jay D, Kakarla U Kumar
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
J Spine Surg. 2019 Sep;5(3):329-336. doi: 10.21037/jss.2019.09.04.
Previous studies have demonstrated that, by using various three-dimensional (3D) printing technologies, synthetic spine models can be manufactured to mimic a human spine in its gross and radiographic anatomy and the biomechanical performance of bony and ligamentous tissue. These manufacturing processes have not, however, been used in combination to create a long-segment, biomimetic model of a patient with scoliosis. The purpose of this study was to describe the development of a biomimetic scoliosis model and early clinical experience using this model as a surgical planning and education platform.
Synthetic spine models were printed to mimic the anatomy and biomechanical performance of 2 adult patients with scoliosis. Preoperatively, the models were surgically corrected by the attending surgeon of each patient. Patients then underwent surgical correction of their spinal deformities. Correction of the models was compared to the surgical correction in the patients.
Patient 1 had a preoperative coronal Cobb angle of 40° from L1 to S1, as did the patient's synthetic spine model. The patient's spine model was corrected to 17.6°, and the patient achieved a correction of 17.3°. Patient 2 had a preoperative mid-thoracic Cobb angle of 88° and an upper thoracic Cobb angle of 43°. Preoperatively, the patient's spine model was corrected to 19.5° and 9.2° for the mid-thoracic and upper thoracic curves, respectively. Immediately after surgery, the patient's mid-thoracic and upper thoracic Cobb angles measured 18.7° and 9.5°, respectively. In both cases, the use of the spine models preoperatively changed the attending surgeon's operative plan.
A novel synthetic spine model for corrective scoliosis procedures is presented, along with early clinical experience using this model as a surgical planning platform. This model has tremendous potential not only as a surgical planning platform but also as an adjunct to patient consent, surgical education, and biomechanical research.
先前的研究表明，通过使用各种三维（3D）打印技术，可以制造合成脊柱模型，以模仿人类脊柱的大体和影像学解剖结构以及骨组织和韧带组织的生物力学性能。然而，这些制造工艺尚未结合使用以创建患有脊柱侧弯患者的长节段仿生模型。本研究的目的是描述一种仿生脊柱侧弯模型的开发以及将该模型用作手术规划和教育平台的早期临床经验。
打印合成脊柱模型以模仿2名成年脊柱侧弯患者的解剖结构和生物力学性能。术前，由每位患者的主刀医生对模型进行手术矫正。然后患者接受脊柱畸形的手术矫正。将模型的矫正情况与患者的手术矫正情况进行比较。
患者1术前从L1至S1的冠状面Cobb角为40°，其合成脊柱模型也是如此。患者的脊柱模型被矫正至17.6°，患者实现了17.3°的矫正。患者2术前胸中段Cobb角为88°，胸上段Cobb角为43°。术前，患者的脊柱模型胸中段和胸上段曲线分别被矫正至19.5°和9.2°。手术后即刻，患者的胸中段和胸上段Cobb角分别为18.7°和9.5°。在这两种情况下，术前使用脊柱模型均改变了主刀医生的手术计划。
本文介绍了一种用于矫正脊柱侧弯手术的新型合成脊柱模型，以及将该模型用作手术规划平台的早期临床经验。该模型不仅作为手术规划平台具有巨大潜力，而且作为患者知情同意、手术教育和生物力学研究的辅助手段也具有巨大潜力。
