数字化腰椎椎弓根导航模板的临床应用

The Clinical Application of Digital Navigation Templates in Lumbar Spine

目的:探讨3D打印腰椎椎弓根导航模板在腰椎退变性疾病中应用的利与弊。方法:回顾性研究10例患者,男6例,女4例,平均年龄76岁,为腰椎间盘突出伴椎管狭窄患者,均使用导航模板但未成功植入螺钉。术前行64排CT扫描采集患者腰椎数据,mimics软件中设计腰椎椎弓根导航模板,利用3D打印技术制作出实体导板并临床应用。结果:椎弓根导航模板共22只,其中多椎体多通道导航模板3只;单椎体双通道导板三种,包括覆盖棘突导板6只、桥式导板8只、桥式椎板限位导板5只。22只腰椎导航模板在术中应用时均失败。结论:3D打印椎弓根导航模板在腰椎退变性疾病中应用时仍存在诸多问题,如导板贴附不佳、导板断裂、导板置入空间不足等问题,有待进一步改善。

Objective： To investigate the problems of the pedicle navigation template used in lumbar surgery. Method： Retrospective study of 10 patients,with lumbar stenosis and lumbar intervertebral disc herniation,6 male,4 female,mean ages was 76 years,used the navigation template but failed to implanted the screws. The lumbar spines data of the patients were collected by 64-row CT scanner. Then the pedicle navigation templates were designed in mimics software. At last,the navigation templates were made by the 3D printer and were used in operations. Result： 22 pedicle navigation templates were made,there were three multiple vertebral and channel navigation templates、six cover spine templates、eight bridge templates、five bridge vertebral plate spacing template. The 22 templates were used in the operation but all failed. Conclusion： There are many problems of pedicle navigation template used in lumbar degenerative disease. For example,the template attached poorly,template fracture and insufficient space. So the 3D printing pedicle navigation template used in lumbar degenerative disease need to be further revision.