本文關(guān)鍵詞： 脊柱 內(nèi)固定器 計算機輔助設(shè)計 組織工程 骨科植入物 脊柱植入物 椎弓根導(dǎo)板 D打印 模擬置釘 準(zhǔn)確性　出處：《中國組織工程研究》2017年23期 　論文類型：期刊論文

【摘要】：背景:手術(shù)精準(zhǔn)度是外科手術(shù)成功的一項保證,以往椎弓根置釘過程在很大程度上憑借術(shù)者經(jīng)驗置釘,存在較大的主觀性,不可避免地造成一定的誤置率。3D打印技術(shù)輔助椎弓根置釘使得置釘過程具有可預(yù)見性,使手術(shù)個體化、精確化、簡單化,有望得到廣泛的推廣應(yīng)用。目的:設(shè)計3D打印的個體化椎弓根導(dǎo)板,體外模擬置釘,探討其在椎體椎弓根置釘術(shù)中的可行性。方法:選擇河北省人民醫(yī)院2016年4至7月收治的11例腰椎退行性病變患者的腰椎薄層CT掃描數(shù)據(jù),三維重建每例患者的L1、L3及L5三個椎體。根據(jù)1例患者的腰椎CT數(shù)據(jù)先行預(yù)實驗:按照術(shù)中置釘原則計算機設(shè)計釘?shù)肋M釘位置、方向,反復(fù)驗證及調(diào)整,設(shè)計出"最佳"導(dǎo)板模型;然后體外模擬置釘,并電鋸剖開驗證置釘效果。結(jié)果與結(jié)論:(1)實驗共應(yīng)用椎弓根導(dǎo)板30個,置釘60枚,模擬置釘過程順利,導(dǎo)板貼服良好,未出現(xiàn)椎弓根螺釘穿破椎弓根皮質(zhì),螺釘位置準(zhǔn)確可靠,效果良好;(2)置釘前后左側(cè)椎弓根進釘?shù)乃矫娼嵌燃笆笭蠲娼嵌茸兓町惥鶡o顯著性意義(P0.05),右側(cè)椎弓根進釘?shù)乃矫娼嵌燃笆笭蠲娼嵌茸兓町愐酂o顯著性意義(P0.05);(3)結(jié)果表明,實驗設(shè)計出的椎弓根導(dǎo)板置釘準(zhǔn)確,模擬置釘前后進釘方向變化無明顯差異,證實了3D打印個體化椎弓根導(dǎo)板的置釘可行性,但尚需進一步臨床驗證。
[Abstract]:Background: surgical accuracy is a guarantee of surgical success in the past pedicle screw placement process to a large extent based on the experience of the operation nail, there is a greater subjectivity. Inevitably resulting in a certain misplacement rate. 3D printing technology assisted pedicle screw placement to make the nail placement process is predictable making the operation individualized accurate and simplified. Objective: to design a 3D printed pedicle guide plate and to simulate nail placement in vitro. Methods: 11 cases of lumbar degenerative diseases treated in Hebei Provincial people's Hospital from 2016 to July were selected. Three-dimensional reconstruction of each patient's L1L3 and L5 vertebrae. According to the lumbar CT data of one patient, the pre-experiment was performed: according to the principle of intraoperative nail placement, the position and direction of the nail were designed by computer. Verify and adjust repeatedly, design the "best" guide plate model; Results and conclusion 30 pedicle guide plates were used in the experiment and 60 nails were placed. The process of simulated nail placement was smooth and the guide plate applied well. No pedicle screw perforated the pedicle cortex, the screw position was accurate and reliable, and the effect was good. (2) there was no significant difference in horizontal angle and sagittal angle between the left pedicle screw and the left pedicle screw before and after screw placement (P 0.05). There was no significant difference in horizontal angle and sagittal angle between the right pedicle screw and the right pedicle screw. The results show that the pedicle guide plate designed by the experiment is accurate and has no obvious difference in the direction of screw entry before and after simulated nail placement, which proves the feasibility of the screw placement of 3D printing individual pedicle guide plate. But it still needs further clinical verification.
【作者單位】： 河北醫(yī)科大學(xué);河北省人民醫(yī)院;
【分類號】：R687.3;TP391.73
【正文快照】： 文章快速閱讀:文題釋義:3D打印技術(shù):開始于20世紀(jì)80年代,經(jīng)過20多年的發(fā)展,目前在逐漸成熟并得到廣泛的應(yīng)用,3D打印技術(shù)輔助椎弓根置釘避免了傳統(tǒng)置釘方法的學(xué)習(xí)曲線及置釘主觀性,使得置釘過程具有可預(yù)見性,使手術(shù)個體化、精確化、簡單化,有望得到廣泛的臨床推廣應(yīng)用。椎弓根，

本文編號：1464415