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2022, Vol. 26 ›› Issue (36): 5798-5806

3D-printed thoracolumbar spine tuberculosis model and guide plate to guide the accuracy and safety of surgery

Yang Yi1, Cao Guangru2, Wang Chong2, Yuan Hao2, Cai Yuqiang2   

  1. 1Department of Orthopedics, The Third Affiliated Hospital (Department of Orthopedics, Zunyi First People's Hospital) of Zunyi Medical University, Zunyi 563000, Guizhou Province, China; 2Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China

  • Received:2021-10-20 Accepted:2021-12-04 Online:2022-12-28 Published:2022-04-27

  • Contact: Cai Yuqiang, Master, Professor, Master’s supervisor, Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China

  • About author:Yang Yi, Master, Department of Orthopedics, The Third Affiliated Hospital (Department of Orthopedics, Zunyi First People's Hospital) of Zunyi Medical University, Zunyi 563000, Guizhou Province, China

  • Supported by:

    Research on Drug Detection and Establishment of Drug Resistance for Clinical Treatment of Major Diseases in Guizhou Province, No. CK-1095 (to CYQ)


Abstract: BACKGROUND: Debridement of spinal tuberculosis lesions with bone graft fusion and internal fixation is a common clinical standard procedure. With the help of the personalized lesion model made by 3D printing, the preoperative planning and the production of surgical nail guides to assist the operation can not only reduce the risk of surgery, but also have higher surgical efficiency and precision compared with traditional methods.
OBJECTIVE: To explore the accuracy and safety of 3D-printed thoracolumbar spine tuberculosis model and guide plate to guide the operation.
METHODS: From July 2017 to December 2019, there were 61 cases of tuberculosis of thoracolumbar spine treated in Affiliated Hospital of Zunyi Medical University. The patients were divided into 3D group and traditional group. Before operation, thin-layer CT image data of the diseased segments of 24 patients in the 3D group were collected and the thoracolumbar spine tuberculosis model was printed with a 3D printer. The pedicle screw guide plate was designed and produced by 3D printing technology, and the model and guide plate were used to formulate the surgical plan and guide the surgical treatment. In the traditional group (n=37), after the CT and X-ray imaging examinations before surgery, the patients were discussed and operated according to the traditional surgical methods. The operation time, intraoperative blood loss, nail placement time, C-arm fluoroscopy number, acceptable nail placement percentage, nail placement accuracy rate, and Cobb angle correction of patients were observed and recorded in 3D group and traditional group. Whether it caused complications such as nerves, blood vessels, and visceral injury was observed.
RESULTS AND CONCLUSION: (1) All patients successfully completed the operation. The operation time, intraoperative blood loss, time spent nailing, and C-arm fluoroscopy times were significantly better in the 3D group than those in the traditional group (P < 0.05). The postoperative hospital stay and postoperative drainage were not statistically significant (P > 0.05). (2) 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). (3) 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). (4) There were no complications such as blood vessels, viscera or nerve injury in the two groups. (5) It is concluded that 3D printing technology is used to simulate thoracolumbar spine tuberculosis model planning operation plan; printing pedicle screw guides to guide nail placement is feasible. They have high efficiency, high precision and high safety, and can provide a reference for the surgical treatment of thoracolumbar spine tuberculosis.
Key words: thoracolumbar tuberculosis, 3D printing, spinal surgery, three-dimensional model, nail placement


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