摘要
目的探讨3D打印技术在颈椎哑铃形肿瘤手术入路选择中的应用。方法回顾性分析2012年8月至2017年2月在我科就诊的17例颈椎哑铃形肿瘤且制作3D打印模型患者的临床资料。其中3名具有高级职称的医师结合或不结合3D打印为每位患者选择手术入路,结合3D打印且最多外科医师选择的手术入路作为最终的手术入路。17例患者手术前后均行JOA评分及Frankel分级。结果结合术前3D打印模型制定的手术入路,所有肿瘤均完全切除。术前不结合3D打印模型,3名外科医师均选择同一手术入路8例患者,2名外科医师选择同一手术入路9例患者,对比结合与不结合3D打印模型的手术入路,3名外科医师共改变手术入路13次,改变手术入路5例患者,包括2例后方入路改为侧方入路,2例侧方入路改为后方入路,1例侧方入路改为前方入路。最后行后方入路手术患者11例,前方入路手术患者1例,侧方入路手术患者3例,枕后远侧入路2例。讨论结合3D打印技术重建颈椎哑铃形肿瘤,能够将局部解剖结构以数字化方式重建打印,对于肿瘤形态、肿瘤与椎体、肿瘤与椎间孔、肿瘤与血管间的关系显示效果优秀。3D打印技术帮助术者精确、直观地了解术区情况,选择优势手术入路,降低手术风险,提高肿瘤的切除率,尤其是对于复杂肿瘤和血管异常走行显示效果优异。
Objective To explore the application of 3D printing technology in surgical approach choice for cervical vertebra dumbbell tumor. Methods Retrospectively analyzed the clinical data of 17 patients with cervical vertebra dumbbell tumor who were admitted into our hospital from August 2012 and February 2017 and reeieved 3D model printing. Three director surgeons chosen surgical approach for each patient with or without 3D printing models. The surgical approach, combined with 3D printing and chosen by most surgeons, was selected as final surgical approach for patients. All the patients were evaluated by JOA score and Frankel grade before and after operation. Results The tumor of patients who selected surgical approach with 3D printing was completely resected. Without 3D printing models in preoperation,3 surgeons selected the same surgical approach for 8 patients ,2 surgeons selected the same surgical approach for 9 patients. Compared with those who selected surgical approach with 3D printing models in preoperation, the 3 surgeons changed surgical approach in a total of 13 times. The surgical approach of 5 patients were changed, including 2 cases changed from posterior approach to lateral approach ,2 cases changed from lateral ap- proach to posterior approach, and 1 case changed from lateral approach to anterior approach. Eventually, 11 cases underwent posterior ap- proach, 1 case underwent anterior approach,3 cases underwent lateral approach and 2 cases underwent far lateral approach. Conclusion Applied of 3D printing in treatment of cervical vertebra dumbbell tumor can rebuild and print local anatomy by digitizing method. It can excellently show the tumor form, relationship of tumor and vertebrae, tumor and foramen intervertebrale, tumor and vessel. 3D printing technology could help surgeon precisely and directly understand the operation area and select advanced surgical approach to reduce surgical risk and increase the resection rate of tumor. And it has an excellent display effect especially for complex tumors and abnormal blood vessels.
出处
《局解手术学杂志》
2018年第2期92-96,共5页
Journal of Regional Anatomy and Operative Surgery
基金
中国博士后科学基金面上项目(2015M582821)
辽宁省自然科学基金(201602794)
关键词
颈椎
3D打印
哑铃形肿瘤
手术入路
cervical vertebra
3 D printing
dumbbell tumor
surgical approach
