中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (9): 1329-1334.doi: 10.3969/j.issn.2095-4344.3758

• 数字化骨科Digital orthopedics • 上一篇    下一篇

3D打印脊柱侧凸矫形器的数字化设计及效果评估

鲁德志1 ,梅  钊2, 李向磊3, 王彩萍4,孙  鑫5,王孝文1 ,王金武5   

  1. 潍坊医学院,1康复医学院,3临床医学院,山东省潍坊市   261053;2华柱医疗科技有限公司(上海),上海市   201204;4上海交通大学生物医学工程学院,上海市   200011;5上海市骨科内植物重点实验室,上海交通大学医学院附属第九人民医院骨科,上海市   200011
  • 收稿日期:2020-04-21 修回日期:2020-04-24 接受日期:2020-05-22 出版日期:2021-03-28 发布日期:2020-12-15
  • 通讯作者: 王金武,博士,教授,主任医师,上海市骨科内植物重点实验室,上海交通大学医学院附属第九人民医院骨科,上海市 200011 王孝文,博士,副教授,潍坊医学院康复医学院,山东省潍坊市 261031
  • 作者简介:鲁德志,男,1994年生,山东省聊城市人,汉族,潍坊医学院康复医学院在读硕士,主要从事脊柱侧凸的康复治疗。
  • 基金资助:
    国家科技部重点研发计划项目(2018YFB1105600);国家科技部重点研发计划项目(2018YFB1107000);2019年度上海市优秀学术/技术带头人计划项目(19XD1434200);上海交通大学医学院附属第九人民医院临床研究型MDT项目(201914);山东省大学生创新创业训练计划项目(S201910438021S);潍坊医学院大学生科技创新基金(KX2019058)

Digital design and effect evaluation of three-dimensional printing scoliosis orthosis

Lu Dezhi1, Mei Zhao2, Li Xianglei3, Wang Caiping4, Sun Xin5, Wang Xiaowen1, Wang Jinwu5   

  1. 1School of Rehabilitation Medicine, 3School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China; 2Huazhu Medical Technology Co., Ltd. (Shanghai), Shanghai 201204, China; 4School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200011, China; 5Shanghai Key Laboratory of Orthopedics, Department of Orthopedics of the Ninth People’s Hospital Affiliated to Medical School of Shanghai Jiao Tong University, Shanghai 200011, China
  • Received:2020-04-21 Revised:2020-04-24 Accepted:2020-05-22 Online:2021-03-28 Published:2020-12-15
  • Contact: Wang Jinwu, MD, Professor, Chief physician, Shanghai Key Laboratory of Orthopedics, Department of Orthopedics of the Ninth People’s Hospital Affiliated to Medical School of Shanghai Jiao Tong University, Shanghai 200011, China Wang Xiaowen, MD, Associate professor, School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
  • About author:Lu Dezhi, Master candidate, School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
  • Supported by:
    the Key Research and Development Project of the Ministry of Science and Technology of China, Nos. 2018YFB1105600, 2018YFB1107000; the Project of Shanghai Excellent Academic/Technical Leader Program in 2019, No. 19XD1434200; the Clinical Research MDT Project of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 201914; the Innovation and Entrepreneurship Training Program for College Students in Shandong Province, No. S201910438021S; the Science and Technology Innovation Fund for College Students of Weifang Medical University, No. KX2019058

摘要:

文题释义:
多学科协作:通常指来自两个以上相关学科,一般包括多个学科的专家,形成相对固定的专家组织,针对某一器官或系统疾病,通过定期、定时、定址的会议,提出诊疗意见的临床治疗模式。其理念是以患者为中心,依托多学科团队,制定规范化、个性化、连续性的综合治疗方案。

背景:目前传统矫形器制造技术需要消耗大量的时间和材料,加工时石膏膨胀系数较大和材料冷却产生回弹会降低矫形器精度,故而计算机辅助设计技术和3D打印技术在矫形器领域的应用正蓬勃开展。
目的:基于多学科协作理念,通过光学扫描、计算机辅助设计及3D打印设计,制作一种新型脊柱侧凸矫形器,并对其矫正效果进行评估。
方法:选择2019年3至10月就诊于上海交通大学附属第九人民医院3D打印中心的青少年特发性脊柱侧凸患者7例,使用3D扫描仪对患者躯干进行扫描取模,应用Rodin4D软件进行虚拟矫形处理,然后导入Magics进行矫形器的镂空设计,通过3D打印技术进行制作。7例患者每日佩戴矫形器时间20 h以上,随访6个月,对干预前后脊柱侧凸的情况进行分析,观察临床疗效。
结果与结论:①非接触式iPad扫描仪成功取模,法国Rodin4D软件内设计矫形器模型、Magics软件对矫形器模型镂空操作,经3D打印方式制作,成功制作出合适的3D打印个性化脊柱侧凸矫形器;②7例患者均有显著改善,未治疗前Cobb角为(29.43±7.68)°,躯干倾斜角为(11.57±2.76)°;治疗6个月后随访Cobb角为(8.71±5.96)°(矫正72%),躯干倾斜角为(3.57±2.57)°(矫正70%),治疗前后Cobb角和躯干倾斜角差异均有显著性意义(P < 0.01);③提示基于多学科协作理念,将数字化医学与3D打印技术联合应用于康复辅具领域,制作个性化脊柱侧凸矫形器的方案具有可行性,并且矫形器的康复疗效显著。
https://orcid.org/0000-0002-2722-6654 (鲁德志) 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 脊柱, 脊柱侧凸, 特发性, 青少年, 3D打印, 计算机辅助设计, 矫形器, 个性化, Cobb角

Abstract: BACKGROUND: At present, the traditional orthosis manufacturing technology needs a lot of time and materials. The larger expansion coefficient of gypsum and the springback of material cooling will reduce the accuracy of orthosis. Therefore, the application of computer-aided design technology and three-dimensional printing technology in the field of orthosis is booming.   
OBJECTIVE: Based on the concept of multidisciplinary collaboration, a new scoliosis orthopedic device was designed and manufactured by optical scanning, computer-aided design and 3D printing, and its correction effect was evaluated.   
METHODS: Seven adolescent idiopathic scoliosis patients, who were treated in the Three-Dimensional Printing Center of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University between March and October 2019, were enrolled in this study. The patient’s trunk was scanned with three-dimensional scanner. Virtual orthopedic treatment was conducted in Rodin4D software. Data were imported into Magics to carry out the hollow out design of orthosis, which was made by three-dimensional printing technology. Seven patients were followed up for 6 months after wearing orthopedic devices for more than 20 hours every day. The scoliosis before and after intervention was analyzed to observe the clinical efficacy. 
RESULTS AND CONCLUSION: (1) The contactless iPad scanner was successfully used for mold taking. The orthopedic model was designed in the French Rodin4D software, and the orthopedic model was hollowed-out by the Magics software. A suitable three-dimensional printed personalized scoliosis orthopedic device was produced through three-dimensional printing. (2) All the seven patients were improved significantly. Cobb angle before treatment was (29.43±7.68)°, and the angle of trunk inclination was (11.57±2.76)°. At 6 months after treatment, Cobb angle was (8.71±5.96)° (corrected 72%), and the angle of trunk inclination was (3.57±2.57)° (corrected 70%). The Cobb angle and angle of trunk inclination were significantly different before and after treatment (P < 0.01). (3) The digital medicine and 3D printing technology are applied in the field of rehabilitation AIDS, based on the concept of multidisciplinary collaboration. The production of personalized scoliosis orthopedic program is feasible, and the orthopedic rehabilitation effect is remarkable. 

Key words: spine, scoliosis, idiopathic, adolescent, 3D printing, computer aided design, orthosis, personalization, Cobb angle

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