Huang Aaron Z B, Mobbs Ralph J
NeuroSpine Surgery Research Group (NSURG), Randwick, Australia.
Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia.
J Spine Surg. 2024 Mar 20;10(1):1-7. doi: 10.21037/jss-23-103. Epub 2024 Mar 15.
Three-dimensional printing (3DP) is increasingly used to individualise surgery and may be an effective tool for representing patient anatomy. Current literature on patient-specific anatomical models (biomodels) for minimally invasive spinal surgery is a limited number of case series and cohort studies. However, studies investigating 3DP in other specialties have reported multiple benefits.
This prospective study considered a series of patients (n=33) undergoing elective endoscopic spinal surgery, including combinations of microdiscectomy (n=27), foraminotomy (n=7), and laminectomy (n=3). These surgeries were conducted at vertebral levels ranging from L2/3 to L5/S1. The surgeon then recorded the impact on preoperational planning, intraoperative decision-making and accelerating the learning curve with a qualitative questionnaire.
There were benefits to planning in 54.5% of cases (n=18), improved intraoperative decision-making in 60.6% of cases (n=20). These benefits were reported more frequently earlier in the cases, with improvements to learning reported in 60% of the first five cases and not in subsequent cases. The surgeon commented that the biomodels were more useful on.
The rates of preoperative and intraoperative benefits are consistent with existing studies, and the early benefit to the learning curve may be suitable for applications to surgical training. Additional research is required to determine the practicality of biomodels and their impact on patient outcomes for endoscopic spinal surgery.
三维打印（3DP）越来越多地用于个性化手术，可能是呈现患者解剖结构的有效工具。目前关于用于微创脊柱手术的患者特异性解剖模型（生物模型）的文献仅有数量有限的病例系列和队列研究。然而，在其他专科领域对三维打印的研究报告了多种益处。
这项前瞻性研究纳入了一系列接受择期内镜脊柱手术的患者（n = 33），包括显微椎间盘切除术（n = 27）、椎间孔切开术（n = 7）和椎板切除术（n = 3）的联合手术。这些手术在从L2/3至L5/S1的椎体节段进行。然后外科医生通过定性问卷记录其对术前规划、术中决策以及加速学习曲线的影响。
54.5%的病例（n = 18）在规划方面有获益，60.6%的病例（n = 20）术中决策得到改善。这些益处更多地在病例早期被报告，在前五个病例中有60%报告学习方面有改善，而后续病例则没有。外科医生评论称生物模型在……方面更有用。
术前和术中获益率与现有研究一致，且对学习曲线的早期益处可能适用于外科培训应用。需要进一步研究以确定生物模型的实用性及其对内镜脊柱手术患者预后的影响。
