Application of a three-dimensional printing model of surgical decompression for cervical ossification of the posterior longitudinal ligament / 中国组织工程研究

ABSTRACT

BACKGROUND:Three-dimensional (3D) printing technology has been successful y used in the field of joint replacement, fracture fixation and spinal implant, but the potential of 3D printing technology in the field of surgery for ossification of posterior longitudinal ligament of cervical spine remains to be discussed. OBJECTIVE:To determine the application value of a 3D printing model in the selection of anterior and posterior surgical decompression for cervical ossification of the posterior longitudinal ligament. METHODS:A retrospective analysis was carried out involving 15 patients with ossification of the posterior longitudinal ligament col ected by computed tomography (CT) and printed by a 3D model pre-operatively between October 2014 and October 2015 in Affiliated Hospital of Xuzhou Medical University. There were isolated type (n=2), segmental type (n=6), continuous type (n=4), and combined type (n=3). The application value of a 3D printer model in patients with ossification of the posterior longitudinal ligament was evaluated by Japanese Orthopedic Association scores, Visual Analog Scale scores, symptoms, and imaging data 1 month pre-operatively, 1 month post-operatively, and at the final fol ow-up. RESULTS AND CONCLUSION:(1) Al 15 patients underwent successful treatment of cervical spine decompression surgery and were fol owed up for 4-16 months. The post-operative symptoms were relieved more significantly than the pre-operative symptoms. Using the posterior approach for cervical spinal surgery, 1 patient had incision fat necrosis and healed after negative pressure drainage. (2) Japanese Orthopedic Association scores 1 month pre-operatively, 1 month post-operatively, and at the final fol ow-up were 9.0±1.6, 11.7±1.8, and 15.5±1.4, respectively;the differences were statistical y significant (P<0.05). Visual Analog Scale scores 1 month pre-operatively, 1 month post-operatively, and at the final fol ow-up were 6.7±2.5, 2.13±1.4, and 1.4±0.5, respectively;the difference was statistical y significant (P<0.05). (3) The imaging results at fol ow-up showed that the anterior interbodies were fused, and the pivot of the posterior operation was healed wel without a re-closing phenomenon. (4) A 3D printer model was shown to be beneficial in observing the characteristics of cervical ossification of the posterior longitudinal ligament, performing the pre-operative evaluation, and simulating the surgical procedure. There was value for the choice of operative approach.