3D打印技术治疗颈椎管狭窄症的初步应用

Primary application of 3D printing technique for cervical pedicle screw placement in treatment of cervical canal stenosis

[目的]探讨3D打印定位导板辅助椎弓根螺钉技术治疗颈椎管狭窄症的置钉准确性及可行性。[方法]2016年6月~2017年5月,对本科收治并采用手术治疗的颈椎管狭窄症患者15例。术前采用3D打印技术设计定位导板,术中依据定位导板确定椎弓根螺钉进钉点和螺钉角度,制备钉道,辅助完成颈椎椎弓根钉置钉。记录手术时间及术中出血量。术后拍摄颈椎CT,使用PSR分级评价螺钉位置准确性。[结果]15例患者共置入椎弓根螺钉92枚。其中PSR Ⅰ级88枚,Ⅱ级4枚,没有出现Ⅲ级螺钉,置钉成功率100%。[结论]3D打印定位导板辅助颈椎椎弓根置钉技术治疗颈椎管狭窄症,螺钉成功率高,临床应用安全性好。

[Objective] To explore the accuracy and feasibility of the 3 D printed guiders for cervical pedicle screw placement in treatment of cervical stenosis.[Methods] From June 2016 to May 2017,15 patients underwent surgical treatment for cervical canal stenosis in our department.Before operation the guiders were made by 3 D printing based on 3 D reconstruction of CT scanning,and then the guider were put at proper positions to introduce pedicle screw placement in correct entering point and angulation during operation.The operation time and intraoperative blood loss were recorded,additionally,the accuracy of screw placed was evaluated by CT scanning and PSR grading.[Results] Of the 15 patients,a total of 92 pedicle screws were inserted,which were ranked as PSR Grade Ⅰ in 88 screws and Grade Ⅱ in 4 screw and no Grade Ⅲ in any screw with successful screw placemen trate of 100%.[Conclusion] The pedicle screw insertion assisted with 3 D printed guider take advantage of significantly improved accuracy and safety for cervical canal stenosis.