下颈椎骨折并脱位手术中 3D 打印导航 模板的有效性与安全性评价

Efficacy and Safety Evaluation of 3D Printing Navigation Template in Lower Cervical Spine Fracture and Dislocation Surgery

摘要:

〔摘 要〕 目的：探究 3D 打印导航模板在下颈椎骨折并脱位手术中的有效性及安全性。方法：2017 年 1 月至 2019 年 1 月，抽取 76 例河南大学第一附属医院收治的下颈椎骨折并脱位患者开展研究，所有患者均经计算机断层扫 描（CT）连续扫描，将所取的影像数据，导入至三维模型中，以 STL 导出，并在三维重建模式下，将椎弓根钉与模 板拟合，手术后，在影像学技术指导下，对螺钉的位置进行评估，同时统计并发症。结果：76 例患者，应用 3D 打印 导航模板后，共置入 360 枚螺钉。术后，X 线片结果显示颈椎骨折复位较好，生理曲度较好。术后 CT 检查，360 枚 椎弓根螺钉，均处于椎弓根内，且导航模板紧密贴合暴露的后颈部结构，具有良好的稳定性。且没有引起血管、脊髓、 神经等的压迫。术后 1 年，X 线片检查，显示骨折愈合良好，没有出现松动或是断钉现象。且所有螺钉置入顺利，没 有出现并发症。结论：在下颈椎骨折并脱位治疗中，3D 打印导航模板的应用，可以提高螺钉置入准确性，且无并发症， 安全性较高。

Abstract:

〔Abstract〕 Objective To explore the efficacy and safety of 3D printing navigation template in the operation of lower cervical spine fracture and dislocation. Methods A total of 76 patients with lower cervical spine fractures and dislocations admitted to the First Affiliated Hospital of Henan University from January 2017 to January 2019 were selected as the research objects. All patients were computed tomography (CT) scan in a row, will take the image data, the import to the 3D model, to STL is derived, and the 3D reconstruction mode, the pedicle screw and template matching. After surgery, the screw position was assessed under the guidance of imaging techniques and complications were counted. Results In 76 patients, 360 screws were inserted after 3D printed navigation templates were used. After surgery, X-ray film results showed that cervical vertebra fracture reduction is good, good physiological curvature. Postoperative CT examination showed that 360 pedicle screws were located in the pedicle, and the navigation template closely fitted the exposed posterior neck structure, showing good stability. There was no compression of blood vessels, spinal cord, nerves, etc. One year postoperatively, X-ray examination showed good union without loosening or nailing. All screws were successfully inserted without complications. Conclusion In the treatment of fracture and dislocation of the lower cervical spine, the application of 3D printed navigation template can improve the accuracy of screw placement, without complications and with high safety