目的 采用3D打印技术建立儿童先天性脊柱半椎体实体模型,探讨该模型在半椎体手术中的应用价值。方法 回顾性分析2012年9月至2016年5月,诊断为先天性脊柱半椎体畸形并进行手术的患者40例,根据患者是否采用3D打印技术辅助治疗分为两组,22例未采用3D打印技术辅助治疗组为对照组; 18例采用3D打印技术辅助治疗为实验组。对比分析两组患者手术置钉时间、置钉准确率、神经血管损伤发生率等情况。结果 对照组共置入椎弓根螺钉102枚,平均置钉时间10～15 min,置钉准确率85.3%(87/102); 实验组共置入椎弓根螺钉94枚,平均置钉时间5～8 min,置钉准确率94.7%(89/94); 两组置钉时间和置钉准确率比较,差异有统计学意义(P<0.01)。所有患者术中及术后均未出现神经、血管损伤等并发症。结论 与传统未使用3D打印技术的徒手置钉技术相比,术前利用患者CT数据通过3D打印技术制作脊柱半椎体模型可以缩短手术置钉时间,提高置钉准确率。
Objective To establish a solid model of congenital spinal hemivertebra body using three-dimensional(3D)printing technology and explore its application value of this model during hemivertebral surgery. Methods Retrospective analyses were performed for 40 surgical children diagnosed with congenital spinal hemivertebra deformity from September 2012 to May 2016.According to whether or not 3D printing technology was employed,they were divided into 2 groups of experimental(n=18)and control(n=22)groups.The duration of nailing operation,accuracy of placement and the incidence of neurovascular injury were compared between two groups. Results In control group,102 pedicle screws were implanted with an average setting time of 10 to 15 min and an accuracy of placement of 85.3%(87/102); In experimental group,94 pedicle screws were implanted with an average setting time of 5 to 8 min and an accuracy of placement of 94.7%(89/94).The duration of nailing operation and accuracy of placement were statistically significant between two groups(P<0.01).There was no perioperative occurrence of such complications as nervous or vascular injury. Conclusion Compared with traditional surgery without 3D printing,using preoperative patient CT data and producing spinal half-vertebral body model through 3D printing may guide operations so as to shorten the time setting nail and improving accuracy.
