Quadrant系統(tǒng)下3D打印導航模塊輔助腰椎精準植釘?shù)膽醚芯?/H1>
發(fā)布時間：2018-06-09 14:28
本文選題：Quadrant系統(tǒng) + 腰椎弓根螺釘 ； 參考：《中國修復重建外科雜志》2017年02期
【摘要】：目的探討Quadrant系統(tǒng)微創(chuàng)通道下3D打印導航模塊輔助腰椎精準植釘?shù)目尚行约隘熜�。方法�?2具成人尸體腰椎(L1~5)標本,經(jīng)CT掃描及三維重建,于Mimics軟件中構(gòu)建通過椎弓根中心長軸的釘?shù)?根據(jù)骨面可剝離范圍設(shè)計并3D打印導航模塊。在尸體標本上實施導航模塊輔助下腰椎椎弓根螺釘植入后,再次CT掃描并三維重建,對手術(shù)前后重建模型進行三維配準,評價植釘符合率。2014年11月—2015年11月,對31例退行性腰椎不穩(wěn)患者行Quadrant系統(tǒng)微創(chuàng)通道下3D打印導航模塊輔助植釘術(shù)。男14例,女17例;年齡42~60歲,平均45.2歲。病程6~13個月,平均8.8個月。單節(jié)段15例,兩節(jié)段13例,三節(jié)段3例。術(shù)前疼痛視覺模擬評分(VAS)為(7.59±1.04)分,Oswestry功能障礙指數(shù)(ODI)評分為(76.21±5.82)分,日本骨科協(xié)會(JOA)評分(9.21±1.64)分。結(jié)果12具標本共植入120枚螺釘,三維配準顯示植釘符合率100%。臨床31例患者共植入162枚螺釘。手術(shù)時間65~147 min,平均102.23 min;術(shù)中出血量為50~116 m L,平均78.20 m L;術(shù)中輻射暴露時間為8~54 s,平均42 s。術(shù)后3~7 d三維配準顯示植釘符合率為98.15%(159/162)。術(shù)后4周VAS評分為(2.24±0.80)分,ODI評分為(29.17±2.50)分,JOA評分為(23.43±1.14)分,與術(shù)前比較差異均有統(tǒng)計學意義(t=14.842,P=0.006;t=36.927,P=0.002;t= 36.031,P=0.001)。31例患者均獲隨訪,隨訪時間8~24個月,平均18.7個月。術(shù)后切口均Ⅰ期愈合,無手術(shù)并發(fā)癥發(fā)生。隨訪期間復查腰椎X線片及CT顯示椎弓根螺釘準確在位,無松動、斷裂,椎間植骨融合良好。結(jié)論Quadrant系統(tǒng)微創(chuàng)通道下采用3D打印導航模塊可以實現(xiàn)手術(shù)微創(chuàng)、少輻射及精準植釘目的。
[Abstract]:Objective to investigate the feasibility and efficacy of 3 D print navigation module assisted precise screw implantation in Quadrant system. Methods 12 adult cadavers with L1 ~ (5) lumbar vertebrae were examined by CT scanning and 3D reconstruction. The nail passage through the long axis of the pedicle was constructed in the mimics software. According to the range of bone dissection, the navigation module was designed and 3D printed. After the pedicle screw implantation was performed on the cadavers, CT scanning and 3D reconstruction were performed again, the reconstruction model before and after operation was registered, and the coincidence rate of screw implantation was evaluated. November 2014 to November 2015. Thirty-one patients with degenerative lumbar spine instability were treated with 3 D print navigation module under Quadrant system. There were 14 males and 17 females, aged 42 to 60 years (mean 45.2 years). The course of disease ranged from 6 to 13 months (mean 8.8 months). There were 15 cases with single segment, 13 cases with two segments and 3 cases with three segments. The preoperative pain visual analogue score (VAS) was 7.59 鹵1.04, and the Oswestry dysfunction index (ODI) score was 76.21 鹵5.82, and the Japanese Orthopedic Association (JOAA) score was 9.21 鹵1.64. Results 120 screws were implanted in 12 specimens. A total of 162 screws were implanted in 31 patients. The operative time was 65 ~ 147min (mean 102.23 mins), the blood loss was 50 ~ 116mL (mean 78.20mL), the radiation exposure time was 854 s (mean 42s). Three dimensional registration on 3 ~ 7 days after operation showed that the coincidence rate of implant nail was 98.15 / 162%. At 4 weeks after operation, the VAS score was 2.24 鹵0.80 and the ODI score was 29.17 鹵2.50. The JOA score was 23.43 鹵1.14, and the difference was statistically significant compared with that before operation. The difference was statistically significant (t = 36.927p 0.002t = 36.031P0.001P 0.002t = 36.031P 0.001n = 36.031), and the follow-up time was 824 months (mean 18.7 months). All the incisions healed in one stage, and no complications occurred. During the follow-up period, X-ray and CT findings showed that the pedicle screw was in the correct position, no loosening and fracture, and good fusion of intervertebral bone graft. Conclusion using 3D print navigation module in Quadrant system can achieve minimally invasive, less radiation and precise nail implantation.
【作者單位】： 福建醫(yī)科大學莆田學院附屬醫(yī)院教學醫(yī)院骨科南方醫(yī)科大學附屬莆田醫(yī)院骨科莆田學院附屬醫(yī)院骨科;
【基金】：福建省中青年教師教育科研項目(JA14274) 福建省自然科學基金項目(2016J01607) 福建省衛(wèi)生和計劃生育委員會青年科研課題(2015-2-32) 福建省醫(yī)學創(chuàng)新課題(2012-CX-34)~~
【分類號】：R687.3
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1 陳宣煌;余正希;吳長福;李星;陳旭;張國棟;鄭祖高;林海濱;;Quadrant系統(tǒng)下3D打印導航模塊輔助腰椎精準植釘?shù)膽醚芯縖J];中國修復重建外科雜志;2017年02期
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5 魏瓊;洪奕珊;;改良體位墊在椎體形成術(shù)中的應用效果觀察[J];現(xiàn)代醫(yī)院;2013年02期
6 劉玉敏;安越;米娜;;胸腰椎后路手術(shù)應用BT-50型脊柱外科手術(shù)床的體會[J];河北聯(lián)合大學學報(醫(yī)學版);2012年01期
7 賴征文;李敏;熊卜貴;李平安;劉云彬;;微創(chuàng)改良TLIF聯(lián)合單側(cè)釘棒系統(tǒng)固定治療腰椎退行性疾病[J];中國矯形外科雜志;2011年10期
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本文選題：Quadrant系統(tǒng) + 腰椎弓根螺釘 ； 參考：《中國修復重建外科雜志》2017年02期
【摘要】：目的探討Quadrant系統(tǒng)微創(chuàng)通道下3D打印導航模塊輔助腰椎精準植釘?shù)目尚行约隘熜�。方法�?2具成人尸體腰椎(L1~5)標本,經(jīng)CT掃描及三維重建,于Mimics軟件中構(gòu)建通過椎弓根中心長軸的釘?shù)?根據(jù)骨面可剝離范圍設(shè)計并3D打印導航模塊。在尸體標本上實施導航模塊輔助下腰椎椎弓根螺釘植入后,再次CT掃描并三維重建,對手術(shù)前后重建模型進行三維配準,評價植釘符合率。2014年11月—2015年11月,對31例退行性腰椎不穩(wěn)患者行Quadrant系統(tǒng)微創(chuàng)通道下3D打印導航模塊輔助植釘術(shù)。男14例,女17例;年齡42~60歲,平均45.2歲。病程6~13個月,平均8.8個月。單節(jié)段15例,兩節(jié)段13例,三節(jié)段3例。術(shù)前疼痛視覺模擬評分(VAS)為(7.59±1.04)分,Oswestry功能障礙指數(shù)(ODI)評分為(76.21±5.82)分,日本骨科協(xié)會(JOA)評分(9.21±1.64)分。結(jié)果12具標本共植入120枚螺釘,三維配準顯示植釘符合率100%。臨床31例患者共植入162枚螺釘。手術(shù)時間65~147 min,平均102.23 min;術(shù)中出血量為50~116 m L,平均78.20 m L;術(shù)中輻射暴露時間為8~54 s,平均42 s。術(shù)后3~7 d三維配準顯示植釘符合率為98.15%(159/162)。術(shù)后4周VAS評分為(2.24±0.80)分,ODI評分為(29.17±2.50)分,JOA評分為(23.43±1.14)分,與術(shù)前比較差異均有統(tǒng)計學意義(t=14.842,P=0.006;t=36.927,P=0.002;t= 36.031,P=0.001)。31例患者均獲隨訪,隨訪時間8~24個月,平均18.7個月。術(shù)后切口均Ⅰ期愈合,無手術(shù)并發(fā)癥發(fā)生。隨訪期間復查腰椎X線片及CT顯示椎弓根螺釘準確在位,無松動、斷裂,椎間植骨融合良好。結(jié)論Quadrant系統(tǒng)微創(chuàng)通道下采用3D打印導航模塊可以實現(xiàn)手術(shù)微創(chuàng)、少輻射及精準植釘目的。
[Abstract]:Objective to investigate the feasibility and efficacy of 3 D print navigation module assisted precise screw implantation in Quadrant system. Methods 12 adult cadavers with L1 ~ (5) lumbar vertebrae were examined by CT scanning and 3D reconstruction. The nail passage through the long axis of the pedicle was constructed in the mimics software. According to the range of bone dissection, the navigation module was designed and 3D printed. After the pedicle screw implantation was performed on the cadavers, CT scanning and 3D reconstruction were performed again, the reconstruction model before and after operation was registered, and the coincidence rate of screw implantation was evaluated. November 2014 to November 2015. Thirty-one patients with degenerative lumbar spine instability were treated with 3 D print navigation module under Quadrant system. There were 14 males and 17 females, aged 42 to 60 years (mean 45.2 years). The course of disease ranged from 6 to 13 months (mean 8.8 months). There were 15 cases with single segment, 13 cases with two segments and 3 cases with three segments. The preoperative pain visual analogue score (VAS) was 7.59 鹵1.04, and the Oswestry dysfunction index (ODI) score was 76.21 鹵5.82, and the Japanese Orthopedic Association (JOAA) score was 9.21 鹵1.64. Results 120 screws were implanted in 12 specimens. A total of 162 screws were implanted in 31 patients. The operative time was 65 ~ 147min (mean 102.23 mins), the blood loss was 50 ~ 116mL (mean 78.20mL), the radiation exposure time was 854 s (mean 42s). Three dimensional registration on 3 ~ 7 days after operation showed that the coincidence rate of implant nail was 98.15 / 162%. At 4 weeks after operation, the VAS score was 2.24 鹵0.80 and the ODI score was 29.17 鹵2.50. The JOA score was 23.43 鹵1.14, and the difference was statistically significant compared with that before operation. The difference was statistically significant (t = 36.927p 0.002t = 36.031P0.001P 0.002t = 36.031P 0.001n = 36.031), and the follow-up time was 824 months (mean 18.7 months). All the incisions healed in one stage, and no complications occurred. During the follow-up period, X-ray and CT findings showed that the pedicle screw was in the correct position, no loosening and fracture, and good fusion of intervertebral bone graft. Conclusion using 3D print navigation module in Quadrant system can achieve minimally invasive, less radiation and precise nail implantation.
【作者單位】： 福建醫(yī)科大學莆田學院附屬醫(yī)院教學醫(yī)院骨科南方醫(yī)科大學附屬莆田醫(yī)院骨科莆田學院附屬醫(yī)院骨科;
【基金】：福建省中青年教師教育科研項目(JA14274) 福建省自然科學基金項目(2016J01607) 福建省衛(wèi)生和計劃生育委員會青年科研課題(2015-2-32) 福建省醫(yī)學創(chuàng)新課題(2012-CX-34)~~
【分類號】：R687.3
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5 魏瓊;洪奕珊;;改良體位墊在椎體形成術(shù)中的應用效果觀察[J];現(xiàn)代醫(yī)院;2013年02期
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