Knorr Patrick, Winkler Dirk, Kropla Fabian, Möbius Robert, Müller Marcel, Scholz Sebastian, Grunert Ronny
Department of Neurosurgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Saxony, Germany.
The Medical Forge, Biosaxony, 04103, Leipzig, Saxony, Germany.
3D Print Med. 2023 Oct 13;9(1):29. doi: 10.1186/s41205-023-00193-9.
The aim of the project was to develop a patient-specific stereotactic system that allows simultaneous and thus time-saving treatment of both cerebral hemispheres and that contains all spatial axes and can be used as a disposable product. Furthermore, the goal was to reduce the size and weight of the stereotactic system compared to conventional systems to keep the strain on the patient, who is awake during the operation, to a minimum. In addition, the currently mandatory computed tomography should be avoided in order not to expose the patient to harmful X-ray radiation as well as to eliminate errors in the fusion of CT and MRI data.3D printing best meets the requirements in terms of size and weight: on the one hand, the use of plastic has considerable potential for weight reduction. On the other hand, the free choice of the individual components offers the possibility to optimize the size and shape of the stereotactic system and to adapt it to the individual circumstances while maintaining the same precision. The all-in-one stereotactic system was produced by means of the Multi Jet Fusion process. As a result, the components are highly precise, stable in use, lightweight and sterilizable. The number of individual components and interfaces, which in their interaction are potential sources of error, was significantly reduced. In addition, on-site manufacturing leads to faster availability of the system.Within the project, a patient-specific stereotaxy system was developed, printed, and assembled, which enables the execution of deep brain stimulation via only three bone anchors located on the skull. Pre-developed MRI markers, which can be screwed directly onto the bone anchors via the sleeves, eliminate the need for a CT scan completely. The fusion of the data, which is no longer required, suggests an improvement in target accuracy.
该项目的目标是开发一种针对患者的立体定向系统，该系统能够同时治疗两个大脑半球，从而节省时间，包含所有空间轴，并且可以作为一次性产品使用。此外，目标是与传统系统相比，减小立体定向系统的尺寸和重量，以便将手术过程中保持清醒的患者所承受的压力降至最低。此外，应避免目前必不可少的计算机断层扫描，以免患者受到有害的X射线辐射，并消除CT和MRI数据融合中的误差。3D打印在尺寸和重量方面最符合要求：一方面，使用塑料在减轻重量方面具有相当大的潜力。另一方面，对各个组件的自由选择提供了优化立体定向系统尺寸和形状并使其适应个体情况的可能性，同时保持相同的精度。一体化立体定向系统是通过多射流熔融工艺生产的。因此，这些组件精度高、使用稳定、重量轻且可消毒。单个组件和接口的数量在相互作用中是潜在的误差源，已显著减少。此外，现场制造使系统能够更快投入使用。在该项目中，开发、打印并组装了一种针对患者的立体定向系统，该系统仅通过位于颅骨上的三个骨锚就能进行深部脑刺激。预先开发的MRI标记物可以通过套管直接拧到骨锚上，完全无需进行CT扫描。不再需要的数据融合表明靶点精度有所提高。
