Design and application of an individual puncture guide device fabricated by three-dimensional printing technology

doi:10.3969/j.issn.2095-4344.0791

Abstract

Abstract:

BACKGROUND: Frequent preoperative fluoroscopic localization of transforaminal endoscopic surgery is harmful to both doctors and patients, so it is necessary to minimize or avoid preoperative fluoroscopy.
OBJECTIVE: To design and built an individual transforaminal endoscopic puncture positioning device using three-dimensional (3D) printing technology and to explore its feasibility of clinical application, the accuracy of the puncture, operation time and the fluoroscopy times.
METHODS: We used Mimics 19.0 to build lumbar model based on the preoperative CT scan data. We simulated the direction and position of the working channel and measured the angle of the working channel, and then puncture guide device was built by 3D printing technology. Forty-five patients undergoing percutaneous endoscopic lumbar discectomy were included in this retrospective study. These patients were divided into two groups. Those received individual puncture guide device were regarded as guide device group (n=22), and those undergoing conventional method were considered as traditional group (n=23). The operation time, puncture times, fluoroscopy times, Visual Analogue Scale scores and Japanese Orthopaedic Association scores were recorded and compared.
RESULTS AND CONCLUSION: (1) The average puncture times was 1.27 ± 0.63 in guide device group and 3.69 ± 0.70 in traditional group, and there were significant differences between two groups (P < 0.001). (2) The fluoroscopy times was 11.59 ± 2.04 in guide device group and 20.39 ± 1.80 in traditional group, and there were significant differences between two groups (P < 0.001). (3) The operation time was 75.44 ± 11.89 minutes in guide device group and 87.39 ± 12.51 minutes in traditional group; there were significant differences between the two groups (P=0.001). (4) Regarding curative effect, there was no significant difference in low back pain and lower extremity pain Visual Analogue Scale and Japanese Orthopaedic Association scores between two groups. (5) The transforaminal endoscopic individual puncture guide device can be constructed by 3D printing technology according to preoperative imaging data. The guiding device can improve the accuracy of puncture during surgery, and effectively reduce the fluoroscopy and puncture times. Thus, it has certain clinical application feasibility.

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

Key words: Lumbar Vertebrae, Intervertebral Disk Displacement, Spinal Puncture, Tissue Engineering

CLC Number:

R318

Yang Jun, Yang Qun, Wang Bo, Liu Yang, Zhang Rui, Jiang Chang. Design and application of an individual puncture guide device fabricated by three-dimensional printing technology [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(19): 3055-3060.

Figures/Tables 2

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