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骨盆骨软骨瘤和神经根的3D打印复合模型。

3D printed composite model of pelvic osteochondroma and nerve roots.

作者信息

Fox Olivia, Kanawati Andrew

机构信息

Department of Orthopaedics, Westmead Hospital, Hawkesbury Road, Westmead, NSW, 2145, Australia.

Harbour Spine Surgeons, 207 Pacific Highway, St Leonards, NSW, 2065, Australia.

出版信息

3D Print Med. 2021 Sep 25;7(1):31. doi: 10.1186/s41205-021-00121-9.

Abstract

BACKGROUND

3D-printing has become increasingly utilized in the preoperative planning of clinical orthopaedics. Surgical treatment of bone tumours within the pelvis is challenging due to the complex 3D bone structure geometry, as well as the proximity of vital structures. We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery.

CASE PRESENTATION

We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The bony pelvis and spine model was created using the CT, whereas the nerve roots were derived from the MRI and printed in an elastic material. 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Pelvic tumour surgery is inherently dangerous due to the delicate nature of the surrounding anatomy. The composite model enabled the surgeon to very carefully navigate the anatomy with a focused resection and extreme care knowing the exact proximity of the L3 and L4 nerve roots.

CONCLUSION

The patient had complete resection of this tumour, no neurological complication and full resolution of his symptoms due to careful, preoperative planning with the use of the composite 3D model.

摘要

背景

3D打印在临床骨科的术前规划中应用越来越广泛。由于骨盆内骨骼肿瘤的3D结构复杂以及重要结构位置临近,骨盆内骨肿瘤的手术治疗具有挑战性。我们展示了一个独特的病例,通过3D打印创建了下腰椎、骨盆及伴行神经根的复合骨骼和神经模型。该3D打印模型精确重建了骨盆肿瘤及穿行神经,用于术前规划,实现了高效且安全的手术。

病例介绍

我们展示了一个独特的病例,通过3D打印创建了下腰椎、骨盆及伴行神经根的复合骨骼和神经模型。骨盆和脊柱的骨骼模型通过CT创建,而神经根则来源于MRI并使用弹性材料打印。3D打印模型精确重建了骨盆肿瘤及穿行神经,用于术前规划,实现了高效且安全的手术。由于周围解剖结构精细,骨盆肿瘤手术本身具有危险性。该复合模型使外科医生能够在精确了解L3和L4神经根确切位置的情况下,极其小心地进行解剖定位,实施精准切除。

结论

由于使用复合3D模型进行了仔细的术前规划,患者的肿瘤得以完全切除,未出现神经并发症,症状完全缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19f2/8466893/980bee9e78d2/41205_2021_121_Fig1_HTML.jpg

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