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Copyright of Tunnel Construction / Suidao Jianshe (Zhong-Yingwen Ban) is the property of Tunnel Construction Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The difficulty of orthopedic surgery for spinal deformity lies in how to determine the position of the vertebral pedicle of the deformed vertebral body. It is difficult to achieve accurate positioning using traditional CT, X-ray examination and other methods, which affects the surgical effect. Recent research shows that computer technology and three-dimensional (3D) printing templates have advantages in improving positioning and nail placement. OBJECTIVE: To explore the effect of computer design combined with 3D printing template on spinal orthopedics on surgical accuracy and correction effect. METHODS: A prospective single-blind randomized controlled study was performed in 73 patients with spinal deformities undergoing orthopedic surgery in the Affiliated Hospital of Chengde Medical College from February 2016 to February 2019. According to the random number table, they were divided into two groups. In the trial group (n=36), computer design combined with 3D printing template was used in orthopedic surgery. In the control group (n=37), conventional orthopedic surgery was applied. The operation situation, the correction rate of Cobb angle, the success rate of nail placement, and the incidence of complications were compared in the two groups. Follow-up was performed for 12 months after operation. Oswestry disability index was compared between the two groups before and 12 months after operation. RESULTS AND CONCLUSION: (1) The operation time of the trial group was shorter than that of the control group. The number of intraoperative X-ray fluoroscopy and intraoperative blood loss were less in the trial group than those in the control group (P < 0.05). (2) The correction rate of Cobb angle was significantly higher in the trial group (89%) than that in the control group (70%) (P < 0.05). The success rate of nail placement was significantly higher in the trial group (100%) than that in the control group (81%) (P < 0.05). (3) There was no statistically significant difference in the incidence of postoperative complications between the two groups (P > 0.05). (4) The scores of social activities, sleep quality, daily activities, and pain in each dimension of the Oswestry disability index of the two groups 12 months after operation were lower than those before surgery, and those scores in the trial group were lower than those in the control group (P < 0.05). (5) These results suggest that computer design combined with 3D printing templates for spinal orthopedic surgery can shorten the operation time, reduce surgical trauma, reduce the number of intraoperative X-ray fluoroscopy, improve surgical accuracy and correction effect, and reduce the degree of postoperative dysfunction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recent clinical studies have found that during the implantation of biomaterials, the internal environment of the body will change to a certain extent, and different levels of immunity and stress responses will occur. There are also obvious differences in the immune and stress responses of different biological materials. OBJECTIVE: To investigate the effect of 3D printed interbody fusion cage on patients with cervical spondylosis of spinal cord type and its effect on serum cortisol and norepinephrine levels. METHODS: Sixty-three patients with cervical spondylotic myelopathy who were admitted to the Affiliated Hospital of Chengde Medical University from July 2015 to July 2018 were selected, including 40 males and 23 females, aged 30-78 years old. The patients were randomly divided into a research group (n=31) and a control group (n=32) according to a random number table. All patients received anterior cervical decompression and bone graft fusion and internal fixation. Patients in the research group were implanted with 3D printed intervertebral fusion cage during operation. The patients in the control group were implanted with polyetheretherketone interbody fusion cage and allogeneic bone. The operation and complications of the two groups were compared. Serum cortisol and norepinephrine levels were detected before and 1 and 3 days after operation. Cervical curvature and intervertebral height were measured before surgery, 1 week, and 6 months after surgery. Axial symptoms were counted at 6 months after surgery. The trial was approved by the Ethics Committee of the Affiliated Hospital of Chengde Medical University. RESULTS AND CONCLUSION: (1) Operation time, intraoperative blood loss and hospitalization time were not significantly different between the two groups (P > 0.05). (2) Among 31 cases, there were 1 case of screw loosening and 1 case of implant movement in the research group. Among 32 cases, there were 3 cases of screw loosening, 3 cases of immune rejection, 2 cases of implant movement, and 1 case of implant collapse in the control group. The incidence of complications was lower in the research group than that in the control group (P < 0.05). (3) At 1 and 3 days after operation, the levels of cortisol and norepinephrine were higher in both groups than those before surgery (P < 0.05), but above levels were lower in the research group than in the control group (P < 0.001). (4) The cervical curvature and intervertebral height at 1 week and 6 months after operation in both groups were higher than those before surgery (P < 0.05), and above indexes were higher in the research group than in the control group (P < 0.05). (5) The axial symptom in the research group was lighter than that in the control group at 6 months after operation (P < 0.05). (6) The results show that the application of 3D printed interbody fusion cage to cervical spondylotic myelopathy can reduce complications, promote the recovery of cervical curvature and intervertebral height, and improve the stability of cervical spine, and the body’s stress response and axial symptoms are mild. [ABSTRACT FROM AUTHOR]

目的探讨计算机辅助设计联合3D打印技术在胸腰椎骨折椎弓根螺钉置入术中的应用效果。方法观察组为2015年1~12月收治的37例胸腰椎骨折患者,对照组为2014年1~12月收治的23例胸腰椎骨折患者。两组均进行椎弓根螺钉置入术,观察组采用计算机辅助设计联合3D打印技术辅助手术,对照组采用常规CT辅助手术治疗。记录两组手术时间、术中出血量、术中X线暴露次数、术中输血量,术中置钉数量、置钉准确数,计算置钉准确率;记录两组术后即刻螺钉矢状面夹角、螺钉内倾角差值、螺钉进钉点水平位置差值,术前、术后6个月伤椎前后高度比、矢状位后凸Cobb角及胸腰椎日本骨科协会(JOA)评分、疼痛视觉模拟评分(VAS),术后6个月并发症发生情况。结果观察组手术时间短于对照组,术中出血量、术中X线暴露次数、术中输血量均少于对照组(P均<0.05)。观察组与对照组术中置钉准确率分别为94.5%、74.6%(P<0.05)。观察组螺钉矢状面夹角、螺钉内倾角差值、螺钉进钉点水平位置差值均低于对照组(P均<0.05)。两组术后6个月伤椎前后高度比、胸腰椎JOA评分均高于术前,矢状位后凸Cobb角、VAS均低于术前(P均<0.05)。观察组术后6个月伤椎前后高度比、胸腰椎JOA评分均高于对照组,矢状位后凸Cobb角、VAS均低于对照组(P均<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论胸腰椎骨折患者采用计算机辅助设计联合3D打印技术辅助进行椎弓根螺钉置入术的手术时间短、损伤小、治疗效果好、安全性高。 [ABSTRACT FROM AUTHOR]

Objective To explore the feasibility of 3 D printing technique for lumbar vertebral pedicle screw implantation. Method We selected the thin CT scan data of 40 healthy human lumbar vertebrae（ L1-5）,and designed the navigation in the pedicle center to obtain the navigation module. Through 3 D printing technology,we printed out the navigation module and lumbar model,and implanted the lumbar vertebral pedicle screw with the assistant of navigation module. Meanwhile,we observed the entry point,screw direction and screw position clearly to determine whether the pedicle cortex was damaged or not. With the assistance of the navigation module,we performed lumbar pedicle screw implantation on adult lumbar（ body） specimens and evaluated the placement effect. Results We applied the navigation module to perform 98 times of placement experiments（ 98 pedicle screws） in both the 3 D printed lumbar models and adult lumbar specimens,including 18 times on L1,L2 22,L3 21,L4 19,and L5 18; no statistically significant difference was found between the virtual screw length and the actual screw length（ all P > 0. 05）. The entry point of all the screws,the direction of the screws and the position of the screw in the pedicle conformed to the predicted nail path,and all the other structures beside the pedicle were not damaged. Conclusion The 3 D printing lumbar navigation module can guide the lumbar screw implantation,and the implanted screws have no deviation in the entry point,the direction of the nail entry and the fixed position. [ABSTRACT FROM AUTHOR]