数字化技术在陈旧性Denis Ⅱ型骶骨骨折合并骶丛神经损伤治疗中的应用

Digital Technology Used in the Surgery of Sacral Fracture(Denis Ⅱ Fracture) with Sacral Neurological Injury

目的:探讨数字化技术在陈旧性DenisⅡ型骶骨骨折合并骶丛神经损伤手术治疗中的临床应用价值。方法:采用计算机三维重建技术结合3D打印模型方法辅助治疗陈旧性DenisⅡ型骶骨骨折合并骶神经损伤患者。术前将患者骨盆区域进行螺旋CT扫描,将其DICOM格式数据传入计算机中,应用mimics软件对骶骨数据进行分割、三维重建。再将骶骨数据转化为STL格式并传输到3D打印机中,打印骶骨实体模型。术前基于mimics软件中虚拟骶骨三维模型与3D打印实体模型明确骨折类型及骶神经损伤原因并模拟手术。术中以实体模型为参照进行骶后路骶板切除骶神经减压术。结果:术中所见骨折形态与骨块位置与术前三维重建、3D打印模型一致。术后随访12个月,患者左下肢疼痛症状明显减轻,无其他手术并发症。结论:采用计算机三维重建技术结合3D打印模型方法辅助治疗陈旧性DenisⅡ型骶骨骨折合并骶神经损伤,可以使术者明确骨折类型与神经损伤部位,从而减少手术时间,达到最佳的手术效果。

Objective:To explore the value of digital technology used in the surgery of sacral fracture(DenisⅡfracture)with sacral neurological damage.Methods:The computerized3D reconstruction technique combined with the3D printing model method were used to treat the patient with old DenisⅡsacral fracture complicated with sacral nerve injury.CT scan was performed on the patient's pelvic region before surgery.The DICOM data of patient was transferred to the computer.The sacral data was segmented and reconstructed by mimics software,and then transferred to the3D printer by STL format to print the sacral solid model.Before surgical treatment,the three-dimensional virtual sacrum model in the mimics software and3D solid model were used to determine the fracture type and the reason of sacral nerve injury.Referring to the solid model of the sacral to finish the surgery of sacral plate resection and sacral nerve decompression.Results:The fracture shape and the position of the bone were consistent with the threedimensional reconstruction and3D printing model.After12months follow-up,the pain of Lower limb was obviously relieved and no other complications were found.Conclusion:The computerized3D reconstruction technique combined with3D printing model can be used to treat the old sacral fracture of Sacral Denis typeⅡwith sacral nerve injury,so that the surgeon can clear the fracture type and nerve injury site,thus reducing the operation time and achieving the best operation effect.