Pearce Patrick, Novak James, Wijesekera Akila, Loch-Wilkinson Thorbjorn, Redmond Michael, Winter Craig, Alexander Hamish, Maclachlan Liam
Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Medicine, The University of Queensland, Brisbane, Australia.
Herston Biofabrication Institute, Metro North, Brisbane, Australia; School of Architecture, The University of Queensland, Brisbane, Australia; School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia.
World Neurosurg. 2023 Jan;169:57-72. doi: 10.1016/j.wneu.2022.10.083. Epub 2022 Oct 27.
Spine surgery addresses a wide range of spinal pathologies. Potential applications of 3-dimensional (3D) printed in spine surgery are broad, encompassing education, planning, and simulation. The objective of this study was to explore how 3D-printed spine models are implemented in spine surgery and their clinical applications.
Methods were combined to create a scoping review with meta-analyses. PubMed, EMBASE, the Cochrane Library, and Scopus databases were searched from 2011 to 7 September 2021. Results were screened independently by 2 reviewers. Studies utilizing 3D-printed spine models in spine surgery were included. Articles describing drill guides, implants, or nonoriginal research were excluded. Data were extracted according to reporting guidelines in relation to study information, use of model, 3D printer and printing material, design features of the model, and clinical use/patient-related outcomes. Meta-analyses were performed using random-effects models.
Forty articles were included in the review, 3 of which were included in the meta-analysis. Primary use of the spine models included preoperative planning, education, and simulation. Six printing technologies were utilized. A range of substrates were used to recreate the spine and regional pathology. Models used for preoperative and intraoperative planning showed reductions in key surgical performance indicators. Generally, feedback for the tactility, utility, and education use of models was favorable.
Replicating realistic spine models for operative planning, education, and training is invaluable in a subspeciality where mistakes can have devastating repercussions. Future study should evaluate the cost-effectiveness and the impact spine models have of spine surgery outcomes.
脊柱手术可解决多种脊柱病变问题。三维（3D）打印在脊柱手术中的潜在应用广泛，包括教育、手术规划和模拟。本研究的目的是探讨3D打印脊柱模型在脊柱手术中的应用方式及其临床应用。
采用多种方法进行范围综述并结合Meta分析。检索了2011年至2021年9月7日的PubMed、EMBASE、Cochrane图书馆和Scopus数据库。结果由两名评审员独立筛选。纳入在脊柱手术中使用3D打印脊柱模型的研究。排除描述钻孔导向器、植入物或非原创研究的文章。根据报告指南提取有关研究信息、模型使用、3D打印机和打印材料、模型设计特点以及临床使用/患者相关结局的数据。使用随机效应模型进行Meta分析。
该综述纳入了40篇文章，其中3篇纳入了Meta分析。脊柱模型的主要用途包括术前规划、教育和模拟。使用了六种打印技术。使用了一系列基底来重建脊柱和局部病变。用于术前和术中规划的模型显示关键手术性能指标有所降低。总体而言，对模型的触感、实用性和教育用途的反馈良好。
在一个错误可能产生毁灭性后果的亚专业领域，复制逼真的脊柱模型用于手术规划、教育和培训具有极高价值。未来的研究应评估成本效益以及脊柱模型对脊柱手术结果的影响。
