The Application Of 3D Printing Model In Percutaneous Transfora Minal Endoscopic Discectomy Teaching

Objective:This study intends to use 3D print model for Percutaneous Transforaminal Endoscopic Discectomy(PTED)teaching,to explore a Method with three-dimensional,intuitive,comprehensive and repeatable operability,but also can effectively improve the quality of the teaching surgery,shorten the PTED cycle.Method:Choose 50 students who attend spine surgery specialist standardized training in Guigang People's Hospital,from December 2014 to December 2016.And they were randomly divided into 3D printing method experimental group and traditional group,there were 25 students in each group.We collected the data of lumbar spine MRI,CT and lumbar segment CTA from the patients in the 3D printing method experimental group.And then the data was imported the Medical Three-dimensional Reconstruction Software like Mimics 19.0,3-matic 11.0 and geomagic studio 12.0 with the "Dicom" format,and the data were reconstructed to required lumbar bone structure,soft tissues(muscles,lumbar arteries,lumbar plexus and lumbar section of skin,fat)and other targets masking(mask)by complex post-processing.After the "Caculate in 3D",we got a digital model with desired tissue.The digital model was imported the 3-matic 11.0 and Geomagic studio 12.0 for modification,registration and integration with " STL "format,in order to form a nearly complete,accurate digitization Model with the lumbar vertebrae and soft tissue comprising the lumbar nerves,blood vessels,muscle,skin and fat,etc.Finally,the model data was imported the high-precision,full-color printer Starasys J 750,and form a 3D printing model for surgery teaching.We used the Corpse,the normal structure of the teaching model or other traditional methods in the traditional group.Finally,we analysised and comparised the indicators about The Teaching Hours,The Theoretical Awareness,The Operation Accuracy,The Test Results and The Teaching Satisfaction between two group,and made the statistics analysis.Results:1 .We established the required high simulation,accurate digital lumbar spine model successfully,by making the MRI,CT and CTA data with"Dicom"format into Mimics 19.0,3-matic 11.0 and Geomagic studio 12.0 or other medical three-dimensional reconstruction software,after the registration?fusion and reconstruction;2.We completed the 3D print real lumbar model successfully,with high precision,color and texture close to the human body,by 3D printing technology.And we completed established PTED teaching content by the assistant of the 3D print lumbar model;3.The experimental group were higher than the traditional group on knowledge of theory,and the difference was statistically significant(P<0.05).The accuracy of the experimental group was better than the traditional group,and the difference was statistically significant(P = 0.0389<0.05).The examination results of the experimental group were significantly better than those in the traditional group,and the difference was statistically significant(P =0.012<0.05).We sent out 50 questionnaires and 49 retracted,effective recovery rate was 98%,the satisfaction degree of the experimental group score was higher than the traditional group,the difference was statistically significant(P<0.01);Each project teaching of experimental group would take less than the traditional group,the experimental group's overall teaching time was 1.12 ± 9.31 min,less than the traditional group of 88.80± 9.152 min,the difference was statistically significant(P<0.01);Conclusion:1.We could obtain an accurate digital protrusion of lumbar intervertebral disc model including bone structure arid the surrounding target soft tissue,by registration.fusion and reconstruction with the MRI and CT data of the patients at the same time.Though combining the high-precision,multi-color and multi-material printing rapid prototyping machine,we could produce a high-definition,accurate,color and texture close to the human body's 3D print lumbar model;2.Compared with the traditional teaching mode,we found that it was more intuitive,comprehensive three-dimensional with obvious repeated operability and superiority,and improved the surgical skills of teaching significantly,shorten the learning cycle of the PTED Effectively,in the 3D printing model is applied to the teaching model of PTED.