| 基于计算机辅助设计与3D打印技术辅助的新型横突拉钩的研制和临床应用 |
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Received:April 28, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘涛 |
LIU Tao |
蚌埠医学院第二附属医院骨科, 安徽 蚌埠 233002 |
Department of Orthopaedics, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 牛国旗 |
NIU Guo-qi |
蚌埠医学院第二附属医院骨科, 安徽 蚌埠 233002 |
Department of Orthopaedics, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233002, Anhui, China |
ssngq@163.com |
| 周功 |
ZHOU Gong |
蚌埠医学院第二附属医院骨科, 安徽 蚌埠 233002 |
Department of Orthopaedics, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 刘路坦 |
LIU Lu-tan |
蚌埠医学院第二附属医院骨科, 安徽 蚌埠 233002 |
Department of Orthopaedics, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 聂虎 |
NIE Hu |
蚌埠医学院数字骨科重点实验室, 安徽 蚌埠 233002 |
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| 期刊信息：《中国骨伤》2022年35卷，第5期，第454-459页 |
| DOI：10.12200/j.issn.1003-0034.2022.05.009 |
| 基金项目:蚌埠医学院自然科学基金面上项目(编号:BYKY18152);蚌埠医学院数字骨科技术研发与应用创新团队项目(编号:BYKC201911) |
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目的:利用计算机辅助设计(computer-aided design,CAD)结合3D打印技术辅助研制新型横突拉钩并探讨其临床应用效果。
方法:利用CAD结合3D打印技术辅助设计研制新型横突拉钩。自2018年9月至2019年9月,将新型横突拉钩应用于临床,对60例需行椎弓根螺钉固定并椎间融合器植骨方式治疗的腰椎单节段病变患者,根据是否应用新型横突拉钩分为新型横突拉钩组和对照组,每组30例。新型横突拉钩组男14例,女16例;年龄(68.0±4.3)岁;L3,4 8例,L4,5 9例,L5S1 13例;腰椎间盘突出5例,腰椎管狭窄20例,退变性腰椎滑脱5例;使用新型横突拉钩进行椎弓根螺钉置入。对照组男15例,女15例;年龄(69.2±4.5)岁;L3,4 8例,L4,5 10例,L5S1 12例;腰椎间盘突出5例,腰椎管狭窄21例,退变性腰椎滑脱4例;使用传统的椎板拉钩进行软组织的牵开及徒手椎弓根螺钉的置入。比较两组患者手术切口长度、置入单枚螺钉时间、透视次数、定位针或螺钉调整次数以及术后72 h手术切口疼痛视觉模拟评分(visual analogue scale,VAS)。
结果:利用CAD结合3D打印技术快速研制出了一种新型横突拉钩。新型横突拉钩组手术切口长度、置入单枚螺钉时间、透视次数、定位针或螺钉调整次数均小于对照组(P<0.05)。术后72 h手术切口疼痛VAS,两组比较差异无统计学意义(P>0.05)。
结论:利用CAD结合3D打印技术研制新型横突拉钩,具有设计方便、研制周期短、成本低等优点,为新型医疗器械的研发提供了一种新的思路,新型横突拉钩具有术中操作简便、固定可靠、对椎旁肌损伤小、方便椎弓根螺钉置入、减少术中透视次数等优点。 |
| [关键词]:计算机辅助设计 打印,三维 腰椎 椎弓根钉 |
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| Development and clinical application of a new transverse process retractor based on computer-aided design and 3D printing technology |
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Abstract:
Objectives: To manufacture a new type of transverse process retractor by using computer-aided design(CAD) combined with 3D printing technology and investigate its clinical application effect.
Methods: A new type of transverse protrusion retractor was developed by CAD combined with 3D printing technology. From September 2018 to September 2019,the new transverse process retractor was applied in clinic. Sixty patients with lumbar single segment lesions who needed treatment by pedicle screw fixation,bone grafting and interbody fusion were divided into new transverse process retractor group and control group,with 30 cases in each group. There were 14 males and 16 females in new type transverse process retractor group,the age was (68.0±4.3) years old on average; lesion segment of 8 cases were L3,4,9 cases were L4,5,13 cases were L5S1;5 cases of lumbar disc herniation,20 cases of lumbar spinal stenosis,5 cases of degenerative lumbar spondylolisthesis;new transverse process retractor was used to pedicle screw placement. While there were 15 males and 15 females in control group,with an average age of (69.2±4.5) years old;lesion segment of 8 cases were L3,4,10 cases were L4,5,12 cases were L5S1;5 cases of lumbar disc herniation,21 cases of lumbar spinal stenosis,4 cases of degenerative lumbar spondylolisthesis;the traditional lamina retractor was used for soft tissue pulling and finished pedicle screw placement by freehand. The length of surgical incision,the time required for inserting a single screw,fluoroscopy times,the times of adjusting the positioning needle or screw in insertion process,and the visual analogue scale (VAS) of surgical incision 72 hours after operation were compared between two groups.
Results: Using CAD and 3D printing technology,a new type of transverse protrusion retractor was developed quickly. The length of surgical incision,the time required for inserting a single screw,fluoroscopy time,and the times of adjusting the positioning needle or screw in insertion process in new transverse process retractor group were less than those in control group(P<0.05). There was no significant difference in VAS of lumbar incision pain at 72 hours after operation between two groups(P>0.05).
Conclusion: Using CAD combined with 3D printing technology to develop a new transverse protrusion retractor has the advantages of convenient design,short development cycle and low cost. It provides a new idea for the research and development of new medical devices. The new transverse process retractor has the advantages of easy operation,reliable fixation,less damage to paravertebral muscle,convenient pedicle screw placement,reducing fluoroscopy time and so on. |
| KEYWORDS:Computer-aided design Printing,three-dimensional Lumbar vertebare Pedicle screws |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘涛,牛国旗,周功,刘路坦,聂虎.基于计算机辅助设计与3D打印技术辅助的新型横突拉钩的研制和临床应用[J].中国骨伤,2022,35(5):454~459 |
| 英文格式: | LIU Tao,NIU Guo-qi,ZHOU Gong,LIU Lu-tan,NIE Hu.Development and clinical application of a new transverse process retractor based on computer-aided design and 3D printing technology[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(5):454~459 |
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