Kaya Ismail, Cingöz Ilker Deniz, Şahin Meryem Cansu, Bozoğlan Emirhan
Neurosurgery, Kutahya Health Sciences University, Kutahya, TUR.
Medical Physics, Kutahya Health Sciences University, Kutahya, TUR.
Cureus. 2021 Feb 2;13(2):e13075. doi: 10.7759/cureus.13075.
Objectives The present study aimed to compare patients in whom an operation plan was prepared before surgery using the three-dimensional (3D) modeling technology with the application of freehand screws using magnetic resonance imaging (MRI) and computed tomography (CT) scan images. Methods The printings and modelings were established in the Training and Research Center. Of 40 patients, 20 underwent surgery with 3D printing (Group 1) and 20 with the freehand technique (Group 2). The surgeries were performed by the same surgeons. Moreover, 5-mm pedicle screws were located in 122 vertebrae in 20 patients in whom 3D modeling was used and in 124 vertebrae in 20 patients in whom this modeling technique was not used. Results The mean time of screw insertion was 2.9 ± 1.2 minutes in the experimental group and 4.7 ± 2.3 minutes in the control group. While the mean amount of bleeding was 7.4 ± 4.1 ml in the experimental group, it was found to be 39.6 ± 14.2 ml in the control group. When the locations of the screws in the experimental group were evaluated, it was seen that 106 (86.9%) screws were 'excellent' and 16 (13.1%) screws were 'good.' When the placement of 124 pedicle screws in the control group was evaluated, it was found that 100 (80.6%) screws were 'excellent,' 20 (17.8%) screws were 'good,' and two (1.6%) screws were 'poor.' Conclusion The use of the improved 3D technology in the neurosurgery field is advantageous for surgeons, as it decreases the preoperative preparation phase, length of operation, and risk of complications.
目的 本研究旨在比较术前使用三维（3D）建模技术制定手术方案并应用徒手置入螺钉的患者与使用磁共振成像（MRI）和计算机断层扫描（CT）扫描图像的患者。方法 在培训与研究中心进行打印和建模。40例患者中，20例行3D打印手术（第1组），20例行徒手技术手术（第2组）。手术由同组外科医生进行。此外，在使用3D建模的20例患者的122个椎体中置入5毫米椎弓根螺钉，在未使用该建模技术的20例患者的124个椎体中置入椎弓根螺钉。结果 实验组螺钉置入平均时间为2.9±1.2分钟，对照组为4.7±2.3分钟。实验组平均出血量为7.4±4.1毫升，对照组为39.6±14.2毫升。评估实验组螺钉位置时，发现106枚（86.9%）螺钉“优秀”，16枚（13.1%）螺钉“良好”。评估对照组124枚椎弓根螺钉的置入情况时，发现100枚（80.6%）螺钉“优秀”，20枚（17.8%）螺钉“良好”，2枚（1.6%）螺钉“差”。结论 在神经外科领域使用改进的3D技术对外科医生有利，因为它减少了术前准备阶段、手术时间和并发症风险。
