Zheng Yi, Yuan Xin-Hua, Wang Wei-Bin, Fu Qing-Song, Wu Jun-Long, Pang Qing-Jiang
Department of Orthopaedics, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China.
Zhongguo Gu Shang. 2020 Sep 25;33(9):797-801. doi: 10.12200/j.issn.1003-0034.2020.09.002.
To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology.
The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded.
The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively.
By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.
探讨基于数字设计和3D打印技术的胸段中上段经皮椎体成形术胸椎椎弓根入路导向模板放置钻孔模板的可行性。
回顾性收集20例胸椎骨折患者的术前CT图像。采用3D软组织打印技术,通过3D成像重建软件对数据进行重建,制作1∶1三维软组织模型。利用Mimics15.0软件的3-matic模块设计椎弓根螺钉通道和数字模板。3D打印机打印导向模板并将三维模板固定在模型上后,置入2.0 mm克氏针,通过CT扫描观察钻孔模板的准确性,经穿刺管注入骨水泥并进行图像验证。记录钉道导向设计时间、导向模板制作时间及成本。
证实了胸段中上段经皮椎体成形术胸椎椎弓根入路三维胸廓模型和数字导向模板的有效性。置入克氏针并通过CT扫描确认螺钉置入的准确性。模板与相应的解剖标志贴合良好,骨水泥填充良好。胸段上段带软组织模型的平均打印时间、钉道导向设计平均时间、导向模板制作平均时间及平均成本分别为(719.00±3.03)分钟、(12.30±1.01)分钟、(55.50±10.30)分钟和3150元。
通过个性化设计和3D软组织打印技术,可实现胸段中上段经皮椎体成形术导向模板的精准放置。