PDF(Pubmed)
Abstract：
BACKGROUND The proper installation for pedicle screws by the traditional method of surgeons dependent on experience is not guaranteed, and educational solutions have progressed from chalkboards to electronic teaching platforms. We designed a case of 3-dimensional printing drill guide template as a surgical application, which can accurately navigate implantation of pedicle screws, and assessed its effect for simulative training. MATERIAL AND METHODS We randomly selected a set of computed tomography data for spondylolisthesis. A navigational template of pedicles and screws was designed by software Mimics and Pro-E, where trajectories of directions and angles guiding the nail way were manipulated for screwing based on anatomy, and its solid model was fabricated by a BT600 3D printer. The screws were integrated and installed to observe their stability. RESULTS The navigational model and custom spine implants were examined to be compatibly immobilized, because they are tolerant to radiation and stable against hydrolysis. The screw size and template were fit accurately to the vertebrae intraosseously, because the pilot holes were drilled and the trajectories were guided by cannulas with visible routes. During the surgical workflow, the patient reported appreciation and showed substantial compliance, while having few complications with this approach. Compared with fluoroscopy-assisted or free-hand techniques, the effect of simulative training during processing was excellent. CONCLUSIONS The surgical biomodel is practical for the procedural accuracy of surgical guides or as an educational drill. This fostering a style of \"practice substituting for teaching\" sets a paragon of keeping up with time and is worthy of recommendation.
摘要：
背景技术依靠经验的外科医生的传统方法不能保证椎弓根螺钉的正确安装。教育解决方案已经从黑板发展到电子教学平台。我们设计了一个三维打印钻孔导向模板的案例作为手术应用，可以准确导航椎弓根螺钉的植入，并评估其模拟训练效果。材料和方法我们随机选择了一组腰椎滑脱的计算机断层扫描数据。通过Mimics和Pro-E软件设计了椎弓根和螺钉的导航模板，在那里，引导钉子路径的方向和角度的轨迹被操纵以根据解剖结构拧紧，它的实体模型是由BT6003D打印机制造的。将螺钉集成并安装以观察其稳定性。结果检查了导航模型和自定义脊柱植入物是否兼容固定，因为它们耐辐射且对水解稳定。螺钉尺寸和模板在骨内与椎骨精确匹配，因为先导孔被钻了，轨迹由可见路线的套管引导。在手术工作流程中，患者表示赞赏并表现出实质性的依从性，而这种方法几乎没有并发症。与透视辅助或徒手技术相比，加工过程中模拟训练效果良好。结论手术生物模型对于手术指南的手术准确性或作为教育训练是实用的。这种培养“实践代替教学”的风格树立了与时俱进的典范，值得推荐。
