The Experimental And Clinical Study Of Prefabricated, Individulized Implant For The Reconstruction Of Skull Defect Based On Digitization Prototyping Technique.

Skull defect of different causes is a common disease in clinical practice , which is seriously harmful to patient's body and mind. The surgical reconstruction of extensive defect has always been a challenge for neurosurgeon for its complicated anatomical struture and irregular three-dimensional curvature. Traditional methods not only require long contouring time, but also largely depend on the experience and skill of surgeon .Even so, the integrality of cranial cavity could only be restored in some degree ,and the aesthetic result is dissatisfactory. As a frontier of advanced industry technique ,digitization proto–typing, combining with modern computer, CT and biomaterial ,is now widespread in medical prctice. This research was aiming to expore the method of prefabricated, individualized implant for reconstruction of Skull defect, by virtue of the techniques of CT, computer imaging processing, digitization prototyping and exact foundry of Titanium .In experimental part ,the animal model was established by creating defects of random size and shape on parieto-occipital zone of dogs, without damaging of dura mater.Basing on data resource from CT continuous thin layer scanning, the individualized implant was prefabricated by 3-D reconstruction, a serial disposal of CT imaging, three dimensional curved recinstruction, computer aided design, prototyping manufacture of three dimensional cranial dodel and individualized implant, and exact foundry of titanium alloy. after implanted in the area, Through CT/MRI scanned in vitro and vivo, We evaluated the existence and extent of CT and MRI artifacts by Titanium alloy implant. (Mental artifacts exists in CT scanning ,but not in MRI.)In clinical application part,72 patients suffered from skull defect have been cured in our hospital, within them 31 patients adopt digitilization forming technique in titanium mesh shaping and received satisfactory results. The main points of this study were as follows:①.neurosurgeons' shaping workload during operations;②. operationtime;③. the approving scale on shaping and complications afteroperations.④. the follow-up after operations.The main results of this study were as follows: Repairing skull by titanium mesh with the technique of digitilization shaping can significantly shorten average operational time to 50士6( min) compared with acrylate group 110士18(min) and titanium mesh traditional handwork shaping group 70士l l(min)(P<0.01);ease neurosurgeons' working intensity of shaping time to5士1(min), compared with acrylate group 30士5(min) and traditional handwork shaping group 20士3(min) (P<0.05); improve patients' approving scale to 100% compared with acrylate group (82%)and traditional handwork shaping group (87.5%) (P<0.05).The main conclusions in the study. The quality of titanium mesh is obviously better than acrylate, repairing skull with digitilization forming technique is better than handwork in any aspects, simplied operation-stepand reduced operationing time,.improved patients' approving scale and reduced complications after operations.