Durusoy Serhat, Akdoğan Volkan, Paksoy Ahmet Emre
Yozgat Bozok Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 66900 Yozgat, Türkiye.
Jt Dis Relat Surg. 2020;31(2):273-280. doi: 10.5606/ehc.2020.73115. Epub 2020 Jun 18.
This study aims to determine the role of computed tomography (CT)-derived templates, produced by three- dimensional (3D) modeling, image processing and printing technology, in percutaneous transsacral screw fixation and evaluate the effects of their use on surgical success.
This prospective study conducted between June 2018 and December 2019 utilized 15 composite pelvis models for transsacral-transiliac screw fixation. For the procedure, modeled templates were utilized for wiring on the left side of the pelvis models, while the conventional method was performed on the right side of the pelvis models. In the computed tomography images acquired after wiring, appropriate wire position was evaluated.
The placed wires held the S1 body appropriately in all of the procedures with or without template use. With the template use, the wires were placed appropriately in the surgical bone corridor suitable for the transsacral-transiliac screw fixation in all of the models. However, with the conventional methods, the wires were not placed in the safe surgical bone corridor in four models. The wire deviation angle in the axial plane was significantly lower in the template group (p=0.001), whereas it was not different between the template group and the conventional method group in the coronal plane (p=0.054). The amount of deviation from the ideal wire entry site was significantly reduced in the template group compared to the conventional method group (p=0.001).
With the use of 3D modeling and printing technology, CT-derived templates can be produced and utilized for transsacral screw fixation procedures and their use increases surgical success by reducing the surgical margin of error.
本研究旨在确定通过三维（3D）建模、图像处理和打印技术生成的计算机断层扫描（CT）衍生模板在经皮骶骨螺钉固定中的作用，并评估其使用对手术成功率的影响。
本前瞻性研究于2018年6月至2019年12月进行，使用15个复合骨盆模型进行骶骨-髂骨螺钉固定。在手术过程中，将建模模板用于骨盆模型左侧的布线，而右侧骨盆模型采用传统方法。在布线后获取的计算机断层扫描图像中，评估导线的合适位置。
在所有使用或未使用模板的手术中，放置的导线均能妥善固定S1椎体。使用模板时，在所有模型中，导线均被正确放置在适合骶骨-髂骨螺钉固定的手术骨通道内。然而，采用传统方法时，有4个模型的导线未放置在安全的手术骨通道内。模板组在轴向平面的导线偏差角度显著更低（p = 0.001），而在冠状平面，模板组与传统方法组之间无差异（p = 0.054）。与传统方法组相比，模板组从理想导线进入点的偏差量显著减少（p = 0.001）。
通过使用3D建模和打印技术，可以制作CT衍生模板并将其用于骶骨螺钉固定手术，其使用通过减少手术误差范围提高了手术成功率。
