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OBJECTIVE@#To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology.@*METHODS@#The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded.@*RESULTS@#The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively.@*CONCLUSION@#By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.
Subject(s)
Humans , Pedicle Screws , Printing, Three-Dimensional , Retrospective Studies , Surgery, Computer-Assisted , VertebroplastyABSTRACT
Objective: To investigate the application of 3D-printed minimally-invasiveguided template in the treatment of recurrent cer-vical cancer after surgery, assisting interstitial brachytherapy. Methods: From July 2017 to April 2018, a total of 10 patients admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei province with recurrent cervical cancer after radi-cal surgery underwent the 3D-printed customized template-assisted interstitial brachytherapy. According to the specific conditions of patients, different vaginal localization templates were selected for CT simulation localization. The main guidance needle space distribu-tion was designed, and 3D minimally-invasive guidance templates were printed. Then, needles were inserted according to the main guide channel of the template commissioned by medical photosensitive resin. The high-risk clinical target volume (HR-CTV) of 6 Gy/fraction was administered (4 to 6 fractions). Results: Overall, 10 patients were treated with implantation for a total of 52 times. Treat-ment with average scanning CT number for each brachytherapy was (1.58±0.70) times. The average elapsed time for each brachythera-py implant treatment, from plug implant to inserting planting needle satisfactorily with the location of the tumor, was (10.88±2.94) minutes. The mean number of metal needles used was (5.69±1.91) in each brachytherapy. The mean D90 value for high-risk clinical tar-get volume (HR-CTV) was (6.41±0.29) Gy. The cumulative D2cm3 values for the bladder, rectum, and sigmoid colon were (4.75±0.37) Gy, (3.93±0.26) Gy, and (4.33±0.24) Gy, respectively. After 3 months of treatment, the efficacy was evaluated in 8 cases with CR and 2 cas-es with PR. Conclusions: The technology of 3D-printed minimally-invasive guided template shows the advantage of accurate location and superior repeatability in the application of interstitial brachytherapy in treating recurrent cervical cancer after operation, which in-volves less time and insertion needles. The patients had minor aches and few complications. The tumor shrank significantly, which indi-cated a bright future of the technology's clinical application.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and advantages of personalized 3D printing-guided template of lateral superior ramous of pubic intramedullary lag screw.</p><p><b>METHODS</b>From July 2015 to December 2016, 20 patients with the superior and inferior ramous of pubis fracture were treated with lag screws placement. All the patients were divided into test group(with guided template) and control group(with general operation). There were 7 males and 3 females with an average age of (46.20±3.03) years old in test group and 6 males and 4 males with (48.50±2.25) years old in control group. There were 6 cases and 5 cases of superior and inferior branches fractures of pubic on the left side and 4 cases and 5 cases on the right side in two groups respectively. The operation time, perspective times and bleeding loss were compared between two groups.</p><p><b>RESULTS</b>The test group and the control group had no statistically significant relative to gender, age, fracture classification. The average time of surgery, average intraoperative fluoroscopy times, mean blood loss in test group were (31.0±5.3) min, (3.5±2.1) times, (75.6±10.5) ml respectively, and in control group were(55.0±6.8) min, (27.6±3.2) times, (85.5±12.5) ml respectively. There were significant Statistical differences between two groups(<0.05) in average operation time and average fluoroscopy times, however, mean blood loss had no significant differences between two groups(>0.05).</p><p><b>CONCLUSIONS</b>The personalized guide template based on 3D printing technology could realize precise placement of the lateral intramedullary lag screw fixation in the superior branch of pubic, also could save the operation time and reduce the times of radiation exposure of patients and surgeons.</p>
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PURPOSE: This study aims to investigate the degree of subjective pain and the satisfaction of patients who have undergone an implant treatment using a computer-guided template. MATERIALS AND METHODS: A survey was conducted for 135 patients who have undergone implant surgery with and without the use of the computer-guided template during the period of 2012 and 2013 in university hospitals, dental hospitals and dental clinics that practiced implant surgery using the computer-guided template. Likert scale and VAS score were used in the survey questions, and the independent t-test and One-Way ANOVA were performed (alpha=.05). RESULTS: The route that the subjects were introduced to the computer-guided implant surgery using a surgical template was mostly advices by dentists, and the most common reason for which they chose to undergo such surgery was that it was accurate and safe. Most of them gave an answer that they were willing to recommend it to others. The patients who have undergone the computer-guided implant surgery felt less pain during the operation and showed higher satisfaction than those who have undergone conventional implant surgery. Among the patients who have undergone computer-guided implant surgery, those who also had prior experience of surgery without a computer-guided template expressed higher satisfaction with the former (P<.05). CONCLUSION: In this study, it could be seen that the patients who have undergone computer-guided implant surgery employing a surgical template felt less pain and had higher satisfaction than those with the conventional one, and the dentist's description could provide the confidence about the safety of surgery.