3D打印技术在脊柱外科中的应用进展

总结国内外脊柱外科，特别是在复杂脊柱疾病中（尤其是严重脊柱畸形和脊柱肿瘤）使用3D打印技术的文献，重点关注提到的3D打印种类、具体应用方法、治疗效果以及成本效益分析。对在脊柱外科手术中使用3D打印技术的文献进行电子检索，国内文献使用中国知网数据库进行检索，国外文献使用PubMed以及Web of Science数据库进行检索。检索词为:脊柱外科、3D打印技术、增材制造、快速成型、脊柱畸形、脊柱肿瘤；英文词为:Spine、Scoliosis、Spinal Tumor、3D printing、Additive manufacturing、Rapid prototyping。并对纳入的文献进行分类总结，检索到文献116篇（中文72篇，英文44篇），进行全文阅读分析后纳入文献35篇（中文15篇，英文20篇）。根据文献内容将3D打印应用分为手术导板、解剖模型以及个体化植入物。纳入文献提到的优点主要有减少手术时间、出血量、术中照射次数以及手术并发症发生率、改善治疗效果、提高患者满意度等。主要局限在于该技术目前缺乏统一标准、额外的打印费用、增加的学习成本、设计3D打印物耗费的时间以及植入物远期可靠性等。3D打印技术在脊柱疾病的治疗中确有价值，但在常见脊柱疾病中使用3D打印技术的意义和价值并不大，只有在较为复杂的病例中使用这项技术才能符合成本效益原则。

Progress on application of 3D printing technology in spine surgery

Abstract: The literatures on the application of three-dimensional (3D) printing technology in spine surgery, especially in complex spinal deformities and spinal tumors are summarized. The review mainly focuses on the types of 3D printing, the specific application methods, treatment effects and cost-benefit analysis. The literatures are searched from China National Knowledge Infrastructure, PubMed and Web of Science. The keywords include Spine, Scoliosis, Spinal Tumor, 3D printing, Additive manufacturing and Rapid prototyping. A total of 116 literatures are retrieved, including 72 papers in Chinese and 44 papers in English. After full-text reading and analysis, only 35 literatures (15 in Chinese and 20 in English) were included in this study. According to the content of the literatures, the applications of 3D printing applied in spinal surgery were divided into surgical guide plates, anatomical models and individualized implants. The advantages mentioned in these literatures includes improvements of treatment outcomes and patient’s satisfaction, reductions in operation time, amount of blood loss, number of intraoperative radiation and incidence of surgical complications. The main limitations of 3D printing technology include the lack of uniform standards, additional printing costs, increasing learning costs, taking a long time to design 3D printed materials, and the lack of long-term follow-up data to evaluate the reliability of implants. 3D printing technology is valuable in the treatment of spinal diseases, but the value of using 3D printing technology in common spinal diseases are not significant. Only using this technology in more complex cases can accord with cost-effective rule.