3D打印技术制备个体化终板匹配颈椎间融合器的初步尝试

目的：探讨3D打印制备个体化颈椎间融合器的可行性并验证其终板匹配性。方法：选取经福尔马林浸泡的成人新鲜尸体标本10具，男女各5具。截取标本的颈1-颈7节段，行CT平扫并将平扫图像导入Mimics软件，制作个体化颈5/6椎间融合器模型。通过3D打印机打印出椎间融合器。对每具标本施行颈5/6椎间隙减压植骨术。术后再次行CT检查，通过打印椎间融合器与上下终板之间的间隙来评价终板匹配性，每个椎间融合器测量36个点，间距＜1mm，匹配性优；1mm≤间距＜2mm，匹配性良；间距≥2mm，匹配性差。结果：大体观察发现椎间融合器与椎间隙嵌合度较好，融合器植入后稳定性较好，无融合器过大不能置入发生，无融合器松动脱落。6例标本（60%）所有测量点匹配性均为优；3例标本（30%）中14个点（3.89%）匹配性良，其中1例6个点、另2例各4个点匹配性良；1例标本（10%）中共3个点（0.83%）匹配性差；共计343个点（95.28%）匹配性优。结论：Mimics软件可很好呈现颈椎椎体和椎间隙解剖结构，并可据此进行颈椎Cage的个体化设计；利用3D打印可实现颈椎Cage产品快速成型，且打印产品与宿主终板匹配满意。

Three-dimensional printing for fabricating individualized endplate matching cervical cage

Objective: To explore the feasibility of fabricating individual cervical cage by three-dimensional printing, verify the endplate matching of cage.Methods: Ten adult cervical specimens were selected to take CT-scan. After original Dicom data imported into the Mimics software, the fifth and sixth cervical vertebra and disc model was created, which was used to design and generate the individual cervical cage based on a three-dimensional printing forming technique. The specimens accepted anterior cervical discectomy and fusion in C5/6 disc . CT-scan was taken postoperatively to access the endplate matching of cage. Matching degree was access in 36 points in each cage, excellent matching was defined if the distance between endplate and cage less than 1mm, good if the distance was greater than or equal to 1mm, and less than 2mm, poor if the distance was greater than or equal to 2mm.Results: Gross observation, the cage was affiliated to veterbral disc, and stability was good. No cage was mobility or too large to implant into veterbral disc. 6 cases (60%) of specimens had excellent matching, Three points (0.83%) match poor in 1 cases (10%) of specimens, 14 points(3.89%) match good in 3 cases (30%) of specimens. A total of 343 points (95.28%) had excellent match.Conclusions: The anatomical structures of cervical vertebral body and intervertebral disc can well present by mimics software, individual cervical cage could be designed based on the model. The rapid prototyping individual cage could be completed through three-dimensional printing, and the printing model matched host endplate well.