3D Printed Thoracolumbar Spine Tuberculosis Model And Guide Plate To Guide The Accuracy And Safety Of Surgery

Objective:Explore the accuracy and safety of 3D printed thoracolumbar spine tuberculosis model and guide plate to guide the operation;analyze the advantages and technical difficulties of using 3D printed pedicle screw guide plate to guide the placement of nails.Methods:From July 2017 to December 2019,there were 61 cases of tuberculosis of thoracolumbar spine treated in our department,including 32 males and 29 females.The patients were divided into 3D group and traditional group;24 patients in the 3D group,11 males and 13 females,with an average age of 40.3±2.7 years;among them,25 thoracic vertebrae and 40 lumbar vertebrae were placed.Before operation,thin-layer CT image data of the diseased segments of this group of patients were collected.After software processing,the thoracolumbar spine tuberculosis model was printed with a 3D printer;the surgical approach,the scope of the lesion removal,the operation route and the pedicle of the thoracolumbar spine tuberculosis model Plan and measure the related bony parameters of nail placement.The pedicle screw guide plate is designed and produced by 3D printing technology,and the model and guide plate are used to formulate the surgical plan and guide the surgical treatment.In the traditional group,there were 37 patients,including 21 males and 16 females,with an average age of 42.5±2.3 years old.Among them,there were 33 thoracic vertebrae and 43 lumbar vertebrae.After the CT and X-ray imaging examinations were completed before surgery,the patients in this group were discussed and operated according to the traditional surgical methods.Observe and record the operation time,intraoperative blood loss,nail placement time,C-arm fluoroscopy number,acceptable nail placement percentage,nail placement accuracy rate,Cobb angle correction of patients in 3D group and traditional group;observe whether it causes nerves and blood vessels Complications such as visceral injury and other surgical complications;compare the intraoperative and postoperative data of the 3D group and the traditional group.Are there statistical differences between the data measured by the preoperative model simulated surgery and the data after the operation in the 3D group,and further evaluation of its accuracy and safety.Results:All 61 patients successfully completed the operation,the operation time,3D group: 185.00 ± 22.60 min,traditional group: 196.00 ± 19.80 min,the difference was statistically significant(P<0.05).The intraoperative blood loss,time spent nailing,C-arm fluoroscopy times,and 3D group were all less than the traditional group,the difference was statistically significant(P<0.05);the postoperative hospital stay and postoperative drainage were not statistically significant.(P>0.05).There was no statistically significant difference between the parameters of 3D printed model data before operation and CT data after operation in the 3D group(P>0.05).There was no significant difference between the two groups in the accuracy of nail placement and the percentage of acceptable nail placement(P>0.05);there were no complications such as blood vessels,viscera and nerve injury in the two groups.Conclusion:3D printing technology is used to simulate thoracolumbar spine tuberculosis model planning operation plan,printing pedicle screw guides to guide nail placement is feasible;3D printing model and pedicle guide guides to guide thoracolumbar spine tuberculosis surgery treatment with high efficiency,high precision and safety The high advantage can provide a reference for the surgical treatment of thoracolumbar spine tuberculosis,and has important clinical guidance significance.