文献类型：期刊文献

中文题名：3D打印模型在颈椎肿瘤手术切除与重建中的应用

英文题名：Application of three-dimensional printing model in surgical resection and reconstruction of cervical tumor

作者：张同同[1];王中华[1];文杰[1];宋玉鑫[2];刘林[1,2]

第一作者：张同同

机构：[1]甘肃中医药大学临床医学院,甘肃省兰州市730000;[2]甘肃省人民医院骨二科,甘肃省兰州市730000

第一机构：甘肃中医药大学临床医学院

年份：2021

卷号：25

期号：9

起止页码：1335

中文期刊名：中国组织工程研究

外文期刊名：Chinese Journal of Tissue Engineering Research

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：甘肃省人民医院院内多学科联合科研项目(18GSSY3-9),项目参与者:王中华、文杰、刘林。

语种：中文

中文关键词：骨;内固定;3D打印;颈椎肿瘤;重建;颈椎;肿瘤;组织工程

外文关键词：bone;internal fixation;3D printing technique;cervical tumor;reconstruction;cervical spine;tumor;tissue engineering

摘要：背景:颈椎解剖结构复杂,肿瘤周围毗邻重要的血管、神经、食管及气管等重要结构,手术难度大。目的:探讨3D打印模型在颈椎肿瘤手术切除与重建中的应用。方法:选择2016年9月至2018年12月甘肃省人民医院收治的颈椎肿瘤患者11例,其中男7例,女4例,年龄35-68岁,术前均行颈椎CT扫描,将CT得到的图像信息保存为DICOM格式,接着将数据导入Mimics三维建模软件,重建出三维模型。最后将重建的结果以STL格式导入3D打印机,按照三维模型逐层叠加打印出1∶1解剖模型。参照3D打印模型,制定颈椎肿瘤手术切除与钢板内固定融合重建计划。术后随访6-12个月,对比手术前后的目测类比评分与Oswestry功能障碍指数。试验获得甘肃省人民医院伦理委员会批准。结果与结论:①11例均手术成功,无脊髓、神经根、椎动脉损伤等严重并发症的发生;术后复查X射线片,显示病变部位完整切除,植入物位置良好,无松动;②11例患者术后1周、1个月及3个月的目测类比评分与Oswestryg功能障碍指数均较术前明显改善(P<0.05);③结果表明,应用3D打印模型能术前制定完整的切除重建计划,包括具体的切除范围、固定节段、螺钉、钢板的大小,熟悉病灶与周围组织的解剖关系,术中避免重要神经、血管的损伤,可降低手术风险低,提高临床疗效。
BACKGROUND:The anatomical structure of cervical spine is complex,and the important structures of blood vessels,nerves,esophagus and trachea are adjacent to the tumor.The operation is difficult.OBJECTIVE:To explore the application of three-dimensional(3D)printing model in surgical resection and reconstruction of cervical tumor.METHODS:Eleven patients with cervical tumors,who were treated in the Gansu Provincial Hospital from September 2016 to December 2018,were selected,including 7 males and 4 females,at the age of 35-68 years.Eleven patients were scanned by cervical CT before operation.The image information obtained by CT was saved in DICOM format,and then the data were imported into Mimics 3D modeling software to reconstruct the 3D model.Finally,the reconstruction results were imported into the 3D printer in STL format,and the 1∶1 anatomical model was printed layer by layer according to the 3D model.According to the 3D printed model,the surgical resection and reconstruction plan of cervical tumor was made.After 6-12 months of follow-up,the visual analogue scale score and Oswestry dysfunction index were compared before and after surgery.This study was approved by the Ethics Committee of Gansu Provincial Hospital.RESULTS AND CONCLUSION:(1)Eleven cases were operated successfully,and no serious complications such as spinal cord,nerve root and vertebral artery injury occurred;postoperative X-ray reexamination showed that the lesion site was completely removed,and the implant was in a good position without loosening.(2)The visual analogue scale score and Oswestry dysfunction index of eleven patients were significantly improved in 1 week,1 and 3 months after operation(P<0.05).(3)The results showed that 3D printing model could make a complete resection and reconstruction plan before operation,including the specific resection scope,fixed segment,screw and steel plate size,familiar with the anatomical relationship between the focus and the surrounding tissue,avoid the injury of important nerves and blood vessels during operation,reduce the risk of operation and improve the clinical effect.