计算机辅助术前矫正模型设计结合3D打印技术在脊柱畸形治疗中的应用

Application of computer-assisted preoperative correction model design combined with 3D printing technology in the treatment of spinal deformities

目的:研究3D打印技术联合计算机辅助设计(CAD)在脊柱畸形疾病治疗中的应用方法和价值。方法:采用回顾性研究方法分析2016年1月～2018年3月在陆军军医大学附属第二医院(新桥医院)骨科治疗的脊柱畸形患者26例,依据影像学数据在计算机上使用Mimics软件制作矫正模型,并采取3D打印方式制作出实体模型用于术中指导手术。分析患者术前形态、术后即刻的矫形效果,以及末次随访结果与矫正设计模型之间的差异情况。结果:26例患者手术均获成功,术前设计模型的的冠状位、矢状位Cobb角度、冠状位平衡、顶椎偏距以及脊柱矢状位轴数据与患者术后各个阶段实际测量值的差异无统计学意义(P>0.05)。结论:合理的术前设计结合高精度3D打印技术制作的模型能很好的为脊柱外科医生提供术中指导,患者术后各次测量数据与术前设计模型一致性较好,可靠地反映了该技术的有效性,值得进一步深入研究。

Objective To investigate the application and value of three-dimensional(3D)printing technology combined with computer-assisted design in the treatment of spinal deformities.Methods A retrospective study was conducted to analyze the clinical data of 26 patients with spinal deformities who were treated in Xinqiao Hospital,the Army Medical University from January 2016 to March 2018.Based on the imaging data,Mimics software was used to establish a correction model on the computer,and then 3D printing technology was adopted to create a solid model for intraoperative guidance.The immediate result of surgical correction was compared with preoperative morphology,and the differences between follow-up results and the designed correction model were compared.Results The surgery was successful in all 26 patients.No significant differences were found in the coronal view,sagittal Cobb angle,C7 plumb line-center sacral vertical line,apical vertebra translation and sagittal vertebral axis between the preoperative design model and the actual measured values at various stages after surgery(P >0.05).Conclusion A reasonable preoperative design combined with model printed by high-precision 3D printing technology provides an excellent guidance for spine surgeons.The postoperative data of the patients included in the study were consistent with the preoperative design model,which reliably reflected the effectiveness of the technique which is worthy of further research.