The design and application of an individualized 3D printing assisted guide plates in assisting sacroiliac screws insertion.

IF 1.5 4区医学 Q3 SURGERY

Computer Assisted Surgery Pub Date : 2022-12-01 DOI:10.1080/24699322.2022.2102542

Mu-Rong You, Zhi-Qiang Fan, Hai-Min Ye, Zhe Wang, Chun-Hua Zou, Xie-Ping Dong

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引用次数: 0

Abstract

Objective: Currently, the sacroiliac screws insertion still faces several challenges in the fixation of pelvic and acetabular injuries. This study was aimed to design a personalized three-dimensional (3D) printing assisted guide plates to assist sacroiliac screws insertion, so as to provide a reference for further clinical applications.

Methods: Eight pelvic specimens (5 males and 3 females) of normal adults were used to simulate actual operation. After thin-layer CT scanning, the 3D models of pelvis were established based on the images data. Furthermore, in Mimics 17.0 software, the screw entry points and screw channels of sacroiliac screws were further simulated and designed, and the appropriate range of the posterior superior iliac spine was selected to establish and print the virtual guide plates. Then, the simulated screws insertion was performed in vitro, the pelvic specimens after screws insertion were scanned again by CT, and the effect of screws insertion was further evaluated.

Results: A total of 16 sacroiliac screw guide plates were designed and printed, and 48 screws were inserted on both sides. Therein, 45 screws were completely located in the sacral vertebra, which was determined as grade 0, with an accuracy rate of 93.2%. The other 3 screws penetrated the anterior cortex or sacral canal of sacral vertebra, including 2 screws in Grade 1 (4.1%) and 1 screw in Grade 2 (2.1%). Compared with the simulated screw channels, the anterior and posterior offset angles of the cross section were (0.912 ± 0.625) ° and (0.802 ± 0.681) ° respectively, with no significant difference (p > 0.05). The upper and lower offset angles of coronal plane were (1.158 ± 0.823) ° and (1.034 ± 0.908) ° respectively, and there was no significant difference (p > 0.05).

Conclusions: 3 D printing guide plates assisted sacroiliac screws insertion can enhance the stability of pelvic posterior ring fixation and assist surgeons to reduce the difficulty of operation.

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个性化3D打印辅助导板在辅助骶髂螺钉置入中的设计与应用。

目的:目前在骨盆和髋臼损伤的固定中，骶髂螺钉置入仍面临一些挑战。本研究旨在设计一种个性化的三维(3D)打印辅助导板来辅助骶髂螺钉置入，为进一步的临床应用提供参考。方法:采用正常成人8例骨盆标本(男5例，女3例)模拟实际手术。经薄层CT扫描后，根据图像数据建立骨盆三维模型。在Mimics 17.0软件中进一步模拟设计骶髂螺钉入钉点和螺钉通道，选择合适的髂后上棘范围建立并打印虚拟导板。然后在体外进行模拟钉入，再次对钉入后的盆腔标本进行CT扫描，进一步评价钉入效果。结果:共设计打印骶髂螺钉导板16枚，两侧共置入螺钉48枚。其中45颗螺钉完全定位于骶椎，评分为0级，准确率为93.2%。其余3枚螺钉穿透骶椎前皮质或骶管，其中1级螺钉2枚(4.1%)，2级螺钉1枚(2.1%)。与模拟螺钉通道相比，前、后横截面偏移角分别为(0.912±0.625)°和(0.802±0.681)°，差异无统计学意义(p > 0.05)。冠状面上下偏移角度分别为(1.158±0.823)°和(1.034±0.908)°，差异无统计学意义(p > 0.05)。结论:3d打印导板辅助骶髂螺钉置入可提高骨盆后环固定的稳定性，帮助外科医生降低手术难度。

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来源期刊

Computer Assisted Surgery Medicine-Surgery

CiteScore

2.30

自引率

0.00%

发文量

审稿时长

10 weeks

期刊介绍： omputer Assisted Surgery aims to improve patient care by advancing the utilization of computers during treatment; to evaluate the benefits and risks associated with the integration of advanced digital technologies into surgical practice; to disseminate clinical and basic research relevant to stereotactic surgery, minimal access surgery, endoscopy, and surgical robotics; to encourage interdisciplinary collaboration between engineers and physicians in developing new concepts and applications; to educate clinicians about the principles and techniques of computer assisted surgery and therapeutics; and to serve the international scientific community as a medium for the transfer of new information relating to theory, research, and practice in biomedical imaging and the surgical specialties. The scope of Computer Assisted Surgery encompasses all fields within surgery, as well as biomedical imaging and instrumentation, and digital technology employed as an adjunct to imaging in diagnosis, therapeutics, and surgery. Topics featured include frameless as well as conventional stereotactic procedures, surgery guided by intraoperative ultrasound or magnetic resonance imaging, image guided focused irradiation, robotic surgery, and any therapeutic interventions performed with the use of digital imaging technology.