微型快速成型导向模板辅助枢椎椎弓根螺钉置钉偏差分析

摘要

Objective To verify the accuracy and deviation of pedicle screw placement in axis assisted by mi-cro rapid prototyping drill guide template. Methods This study was based upon CT scans in axis of 12 subjects from Three Gorges University People's Hospital between Sep. 2012 and Sep. 2015, using the Mimics10.01 for reconstruction and then UG7.0 for design of deviation detection plate and the axial inverse plate. Cervical model and guide plate were made by desktop 3D printing machine, and guide plate and the Kirschner wire of 3 mm in diameter were used to simu-late the cervical screw drilling. The vernier caliper was applied to measure the length of Kirschner wire in the vertebra, displacement in the X axis and Y axis in deviation detection plate. The obtained data was compared with the computer measurement. Results No statistically difference existed in the length of Kirschner wire in the vertebra, displacement in the X axis and Y axis between the vernier caliper measurement group and the computer measurement group (P>0.05). Conclusion Micro rapid prototyping drill guide template could reduce the designing and manufacturing time and at the same time improve the surgery safety of posterior pedicle screw placement in axis.%目的：验证微型快速成型导板辅助后路枢椎椎弓根螺钉置钉的准确性及其偏差分析。方法随机选取2012年9月至2015年9月三峡大学人民医院12例受试者的枢椎CT连续扫描数据，利用Mimics10.01重建后，导入UG7.0，设计偏差检测板及枢椎后表面互补基板。在桌面3D打印机器制作颈椎及导板模型，利用导板、直径3 mm克氏针在3D颈椎模型模拟置钉。最后利用游标卡尺在偏差检测导板上测量出钉点距X轴、Y轴位移，克氏针置入长度，并同计算机测量数值比较。结果游标卡尺测量组同计算机测量组比较，在进钉深度、X轴位移、Y轴位移方面差异均无统计学意义(P>0.05)，导板置钉准确性可靠。结论使用微型导板在减少设计、制造时间同时能有效的辅助枢椎椎弓根螺钉置入，提高了该手术的安全性,同时为数字化导航手术的实现奠定了基础。