3D打印个体化导板辅助颈椎椎弓根螺钉置钉的可行性研究

Feasibility of 3D-printed patient-specific drill template for cervical pedicle screw placement

目的计算机辅助设计结合3D打印制作个体化颈椎椎弓根螺钉导板，探讨导板辅助颈椎椎弓根螺钉置入的效果。方法选择成人尸体颈椎标本8具，其中男4具，女4具。通过CT扫描获取DICOM数据，Mimics软件重建，分别在C3～6椎体两侧椎弓根螺钉模拟置钉，并设计出椎弓根螺钉导板，以光敏树脂为材料3D打印出导板，在尸体颈椎上辅助置入椎弓根螺钉，通过X线和CT观察置钉准确性。结果8具尸体颈椎标本共置入椎弓根螺钉64枚，其中62枚完全在椎弓根内，2枚向外穿破至椎动脉孔，置钉准确性为97％。结论3D打印个体化导板辅助颈椎椎弓根螺钉的置入能够降低操作难度、提高置钉准确性，具有较好的应用前景。

Objective To evaluated the effect of computer-assisted pedicle screw placement using the 3D-printed patient-specific drill template. Methods CT scan was performed on each cervical vertebra of 8 cadavers （4 males and 4 females） and data were saved in Dicom format. 3D reconstruction models were generated with the Mimics to simulate bilateral C3-C6 pedicle screw placement and a drill template was designed. The drill template was manufactured by 3D printing using the photosensitive resin and applied to assist the pedicle screw placement. Accuracy of screw placement was assessed with radiographic examination. Results A total of 64 pediele screws were inserted with 62 screws entirely inside the pedicle and 2 screws violated into vertebral artery orifice. Accuracy of screw placement was 97%. Conclusions 3D-printed patient-specific drill template is easy to apply and accurate in assisting cervical screw placement. The potential use of drill template to place cervical pedicle screws is promising.