Preoperative planning and operative simulation of three-dimensional printing-assisted upper cervical spine tumor model

doi:10.3969/j.issn.2095-4344.1007

Abstract

Abstract:

BACKGROUND: At present, most of the finite element models of upper cervical spine tumors are established based on CT scanning combined with enhanced image data. The three-dimensional printing simulation model has certain errors with the intraoperative actual tumor. We have established the model based on CT and MR, which is realistic.

OBJECTIVE: To investigate the application of three-dimensional printed upper cervical tumor model for preoperative planning and simulated surgery.

METHODS: Twenty patients with upper cervical dumbbell tumors (Toyama IIa, IIIa, and V type) admitted in Zhongshan Hospital, Xiamen University from 2015 to 2017 were enrolled, and allocated into two groups (n=10 per group) according to surgical scheme. In the three-dimensional printing group, preoperative CT and MR data of the upper cervical dumbbell tumors were obtained to reconstruct the patients with individualized upper cervical tumor models before surgery, and underwent resection of tumors and reconstruction of spinal stability with atlantoaxial pedicle internal fixation by one-stage posterior approach. The conventional group received conventional surgery. The operation time, blood loss, hospitalization time and postoperative 1-year Japanese Orthopaedic Association improvement rate were compared between two groups.
RESULTS AND CONCLUSION: (1) The three-dimensional model could clearly reveal the morphology of the tumor and its spatial relationship with the adjacent blood vessels and the upper cervical spine, and simulate the model in vitro. The intraoperative three-dimensional printing model guided tumor resection and reconstructed upper cervical stability. (2) Compared with the conventional group, the operation time, blood loss, and hospitalization time in the three-dimensional printing group were significantly decreased (P < 0.05). (3) The postoperative 1-year Japanese Orthopaedic Association improvement rate in the three-dimensional printing and conventional groups was (93.0±2.8)% and (75.0±2.3)%, respectively (t=5.634, P < 0.05). (4) All patients showed no internal fixation loosening or kyphosis during follow-up. (5) These results indicate that the three-dimensional-printed upper cervical tumor models are technically feasible, which can effectively assist the development of complex upper cervical diseases surgery program and simulate surgery; therefore, it can help to improve the surgical efficiency and safety.

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: Cervical Vertebrae, Neoplasms, Tissue Engineering

CLC Number:

R445

Chen Yongjun, Zhong Hua, Hua Qiang, Lin Yongxiang, Li Hua, Hu Zhiping, Duan Shaoyin, Zhao Huiyi . Preoperative planning and operative simulation of three-dimensional printing-assisted upper cervical spine tumor model [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(35): 5614-5619.

Figures/Tables 4

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