Huang Xin, Luo Qipeng, Liang Chen, Wang Yixuan, Jia Donglin, Li Shuiqing, Guo Xiangyang
Department of Pain Medicine, Peking University Third Hospital, Peking University Health Science Center, Beijing, China.
Department of Anesthesiology, Peking University Third Hospital, Peking University Health Science Center, Beijing, China.
Front Neurosci. 2024 Apr 12;18:1323262. doi: 10.3389/fnins.2024.1323262. eCollection 2024.
The learning curve for percutaneous endoscopic transforaminal discectomy (PETD) is steep, especially for the puncturing and localization procedures. The implementation of 3D printing technology may solve this problem.
A novel individualized 3D-printing template (3D-PT) was designed and utilized in PETD. A prospective randomized controlled trial was performed. A total of 28 patients with lumbar disc herniation treated with PETD were analyzed. Of these, 14 patients were treated with the assistance of 3D printing technology (3D-PT group) in conjunction with fluoroscopy, while the remaining 14 patients were treated exclusively under the guidance of C-arm fluoroscopy (control group).
The number of puncture attempts in the 3D-PT group was significantly less than in the control group (1.36 ± 0.63 vs. 6.07 ± 3.08, = 0.000). The 3D-PT group exhibited a significant reduction in both intraoperative puncture fluoroscopies (2.71 ± 1.27 vs. 12.14 ± 6.15, = 0.000) and the overall number of fluoroscopies (2.71 ± 1.27 vs. 17.43 ± 6.27, = 0.000). In the 3D-PT group, there was a significant reduction in both the puncture time (5.77 ± 1.82 vs. 13.99 ± 4.36, = 0.000) and the total operation time (60.39 ± 9.78 vs. 76.25 ± 17.78, = 0.007). Complications were not observed in either group.
The application of the novel individualized 3D-PT for PETD is effective and safe. The technique has substantial potential and is worth widely promoting.
经皮内镜下椎间孔入路椎间盘切除术（PETD）的学习曲线较陡，尤其是穿刺和定位操作。3D打印技术的应用可能会解决这一问题。
设计并在PETD中使用了一种新型个体化3D打印模板（3D-PT）。进行了一项前瞻性随机对照试验。共分析了28例行PETD治疗的腰椎间盘突出症患者。其中，14例患者在3D打印技术辅助下（3D-PT组）结合透视进行治疗，其余14例患者仅在C型臂透视引导下治疗（对照组）。
3D-PT组的穿刺尝试次数显著少于对照组（1.36±0.63比6.07±3.08，P=0.000）。3D-PT组术中穿刺透视次数（2.71±1.27比12.14±6.15，P=0.000）和总透视次数（2.71±1.27比17.43±6.27，P=0.000）均显著减少。3D-PT组的穿刺时间（5.77±1.82比13.99±4.36，P=0.000）和总手术时间（60.39±9.78比76.25±17.78，P=0.007）均显著缩短。两组均未观察到并发症。
新型个体化3D-PT应用于PETD有效且安全。该技术具有很大潜力，值得广泛推广。
