3D打印技术辅助治疗髋臼肿瘤1例报告及文献复习

Assisted treatment of acetabulum tumor with 3D printing technology:A case report and literature review

目的:采用3D打印钛合金骨盆假体对1例转移性髋臼肿瘤患者进行骨盆重建,探索治疗髋臼肿瘤的新方法。方法:对1例转移性髋臼肿瘤患者行骨盆CT扫描,采用Mimics 14.0软件进行三维重建,制备1∶1比例3D打印骨盆光固化树脂模型,根据术前规划的截骨范围设计并制备3D打印个体化截骨导板,骨盆假体外形设计以患者健侧半骨盆镜像图像为基础。设计并制造3D打印钛合金骨盆假体,术中采用截骨导板对骨盆进行截骨,并根据术前设计位置植入骨盆假体进行骨盆重建。结果:术后12个月内对患者进行多次随访,复查骨盆X线片。骨盆X线显示假体位置良好,无移位,达到对骨盆的解剖重建。术后12个月随访记录,健康调查简表(SF-36)评分为75.35分,肌肉骨骼肿瘤协会(MSTS)评分为11分,髋关节Harris评分为52分。术后患者恢复了下肢基本功能,在支具辅助下可以站立及正常行走。结论:本研究中3D打印骨盆假体达到了对患者骨盆的精确重建,改善了患者术后运动功能。

Objective：To use 3 Dprinting titanium alloy pelvic prosthesis to reconstruct the pelvis in a patient with metastatic acetabulum tumor,and to explore a novel method in the treatment of acetabulum tumor.Methods：One patient with metastatic acetabulum tumor was selected.The pelvic CT scan was conducted in the patient.Three-dimensional reconstruction of pelvic CT was conducted using Mimics 14.0 Software.The 3 D printing stereo lithography apparatus resin pelvic model with 1∶1 scale was manufactured.The 3 D printing osteotomy guide was designed and manufactured in accordance with the preoperative designed osteotomy scope;3 D printing titanium alloy pelvic prosthesis was designed on the basis of mirror image normal side hemi-pelvis and manufactured by electron beam melting 3 D printing technology.After the osteotomy assisted with 3 D printing osteotomy guide,pelvic prosthesis was implanted to the designed location.Results：Several follow-ups were reviewed in the patient within postoperative 12 months.The results of X-ray image showed there were no signs of pelvic prosthesis displacement and obvious migration.The SF-36 score（the MOS item shorted from health survey）was 75.35 points at 12 months after operation;MSTS was 11 points at 12 months after operation.The Harris score of affected side hip joint was 52 points at 12 months after operation.The motion function of lower limbs after operation of the patient was restored.The daily actions such as walking and standing could be done by herself with the assistance of crutch.Conclusion：In this study,3 Dprinting pelvic prosthesis achieve the accurate reconstruction of pelvis and ameliorate the postoperative motion function of the patient.