三维打印指南模板辅助皮椎间盘（PVP）
Summary
在这里，我们提出了一个三维打印指南模板的皮椎骨。T11椎骨压缩性骨折患者被选择作为案例研究。
Abstract
皮下椎骨成形术（PVP）被认为是骨质椎骨压缩性骨折引起的背痛的有效治疗。PVP的准确性主要取决于外科医生在传统手术中的经验和多荧光镜。世界各地都报告了穿刺相关的并发症。为了使手术更加精确，降低穿刺相关并发症的发生率，我们的团队对PVP应用了三维打印指南模板来修改传统程序。该协议介绍了如何在软件中将目标椎骨DICOM成像数据建模为三维，如何模拟此三维模型中的操作，以及如何利用所有手术数据重建患者特定的应用模板。使用此模板，外科医生可以准确地识别合适的穿刺点，以提高手术的准确性。整个方案包括：1）骨质椎骨压缩性骨折的诊断;2） 目标椎骨CT成像的采集;3）模拟软件中的操作;4）设计制作三维打印导板模板;5） 将模板应用到操作过程中。
Introduction
骨质疏松性骨折（OVCF）作为各种骨质疏松性骨折中最常见的类型性骨折，是当今临床上备受关注的临床问题。根据目前的指南建议，皮皮椎骨成形术是临床治疗骨质椎骨压缩性骨折1最有效的微创方法之一。
传统上，外科医生在C-arm荧光镜的指导下进行皮下椎骨整形手术，以治疗椎骨压缩性骨折，以恢复压缩的椎体，缓解早期疼痛2。即使是有经验的外科医生，只要依靠个人经验，就能在确认合适的穿孔点时出错。此操作可能导致一些与穿刺相关的并发症（例如，水泥渗入周围组织、神经根损伤、脊髓内造脑肿等3、4、5）;此外，近50%的患者有局部并发症从传统的PVP与95%的并发症来自水泥泄漏到周围组织或栓塞静脉6。随着精密手术的出现，三维打印指南模板已用于许多脊柱手术7，因为它可以提高程序的准确性，减少难度，并尽量减少操作风险。在这里，我们将三维打印指南模板应用于PVP，使外科手术更加精确，并降低穿刺相关并发症的发生率。与传统方法相比，3D打印指南模板辅助手术有1）手术穿刺精度提高，2）手术过程中辐射暴露最小化，3）缩短手术时间，4）减少手术时间。穿刺相关并发症的概率。
Protocol
Representative Results
Discussion
皮皮椎骨成形术（PVP）被认为是治疗骨质椎骨压缩性骨折的最好方法之一，因为它有一些明显的优点：它是微创的;出血较少，恢复迅速。传统的PVP主要由C-arm荧光镜引导，需要反复的荧光镜来确定安全和理想的穿刺点、穿刺角度和方向，这增加了术中辐射剂量和操作时间10.此外，手术的成功率主要取决于外科医生的经验。然而，仍然有1.2%-15.7%的错误率和0-7.42%?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
该研究由北京市科学技术委员会资助（中国，中国，中国，Z.Z181100001718078）。
Materials
| X-ray machine | Company Philips | machine | |
| Magnetic resonance image machine | Company GE | machine | |
| computer tomography | Company GE | machine | |
| HORI 3D printing machine | Company of Beijing Huitianwei Technology co. ltd. | machine | |
| Geomagic Design X | 3D Systems Company | software | |
| Materialise Interactive Medical Image Control System | Materialise Company | software | |
| VertePort needle | Stryker Company | operation appliance | |
| Spineplex | Stryker Company | operation appliance | |
| Percutaneous Cement Delivery System | Stryker Company | operation appliance | |
| Spirit Level Plus | IOS App store | gradientor |
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