Extensive lesions involving the posterior quadrant of the cerebral hemisphere （temporal, parietal, and occipital lobes） induce intractable epilepsy. These patients are potential candidates for surgical treatmenttu. ...Extensive lesions involving the posterior quadrant of the cerebral hemisphere （temporal, parietal, and occipital lobes） induce intractable epilepsy. These patients are potential candidates for surgical treatmenttu. Maintenance of isolated nerve tissue activity after surgery plays a crucial role in the neuroprotective effects of neurosurgery treatment. Disconnection surgery of the posterior quadrant is used to completely isolate nerve fibers, while blood supply at the isolated lobes is maintained. Subsequently, cavities caused by cystic or necrotic nerve tissues should be reduced as much as possible,展开更多
目的探讨Quadrant系统微创通道下3D打印导航模块辅助腰椎精准植钉的可行性及疗效。方法取12具成人尸体腰椎(L1~5)标本,经CT扫描及三维重建,于Mimics软件中构建通过椎弓根中心长轴的钉道,根据骨面可剥离范围设计并3D打印导航模块。在尸...目的探讨Quadrant系统微创通道下3D打印导航模块辅助腰椎精准植钉的可行性及疗效。方法取12具成人尸体腰椎(L1~5)标本,经CT扫描及三维重建,于Mimics软件中构建通过椎弓根中心长轴的钉道,根据骨面可剥离范围设计并3D打印导航模块。在尸体标本上实施导航模块辅助下腰椎椎弓根螺钉植入后,再次CT扫描并三维重建,对手术前后重建模型进行三维配准,评价植钉符合率。2014年11月—2015年11月,对31例退行性腰椎不稳患者行Quadrant系统微创通道下3D打印导航模块辅助植钉术。男14例,女17例;年龄42~60岁,平均45.2岁。病程6~13个月,平均8.8个月。单节段15例,两节段13例,三节段3例。术前疼痛视觉模拟评分(VAS)为(7.59±1.04)分,Oswestry功能障碍指数(ODI)评分为(76.21±5.82)分,日本骨科协会(JOA)评分(9.21±1.64)分。结果12具标本共植入120枚螺钉,三维配准显示植钉符合率100%。临床31例患者共植入162枚螺钉。手术时间65~147 min,平均102.23 min;术中出血量为50~116 m L,平均78.20 m L;术中辐射暴露时间为8~54 s,平均42 s。术后3~7 d三维配准显示植钉符合率为98.15%(159/162)。术后4周VAS评分为(2.24±0.80)分,ODI评分为(29.17±2.50)分,JOA评分为(23.43±1.14)分,与术前比较差异均有统计学意义(t=14.842,P=0.006;t=36.927,P=0.002;t=–36.031,P=0.001)。31例患者均获随访,随访时间8~24个月,平均18.7个月。术后切口均Ⅰ期愈合,无手术并发症发生。随访期间复查腰椎X线片及CT显示椎弓根螺钉准确在位,无松动、断裂,椎间植骨融合良好。结论Quadrant系统微创通道下采用3D打印导航模块可以实现手术微创、少辐射及精准植钉目的。展开更多
基金The Science Fund of Health Bureau of Tianjin,No.2013KZ046
文摘Extensive lesions involving the posterior quadrant of the cerebral hemisphere （temporal, parietal, and occipital lobes） induce intractable epilepsy. These patients are potential candidates for surgical treatmenttu. Maintenance of isolated nerve tissue activity after surgery plays a crucial role in the neuroprotective effects of neurosurgery treatment. Disconnection surgery of the posterior quadrant is used to completely isolate nerve fibers, while blood supply at the isolated lobes is maintained. Subsequently, cavities caused by cystic or necrotic nerve tissues should be reduced as much as possible,
文摘目的探讨Quadrant系统微创通道下3D打印导航模块辅助腰椎精准植钉的可行性及疗效。方法取12具成人尸体腰椎(L1~5)标本,经CT扫描及三维重建,于Mimics软件中构建通过椎弓根中心长轴的钉道,根据骨面可剥离范围设计并3D打印导航模块。在尸体标本上实施导航模块辅助下腰椎椎弓根螺钉植入后,再次CT扫描并三维重建,对手术前后重建模型进行三维配准,评价植钉符合率。2014年11月—2015年11月,对31例退行性腰椎不稳患者行Quadrant系统微创通道下3D打印导航模块辅助植钉术。男14例,女17例;年龄42~60岁,平均45.2岁。病程6~13个月,平均8.8个月。单节段15例,两节段13例,三节段3例。术前疼痛视觉模拟评分(VAS)为(7.59±1.04)分,Oswestry功能障碍指数(ODI)评分为(76.21±5.82)分,日本骨科协会(JOA)评分(9.21±1.64)分。结果12具标本共植入120枚螺钉,三维配准显示植钉符合率100%。临床31例患者共植入162枚螺钉。手术时间65~147 min,平均102.23 min;术中出血量为50~116 m L,平均78.20 m L;术中辐射暴露时间为8~54 s,平均42 s。术后3~7 d三维配准显示植钉符合率为98.15%(159/162)。术后4周VAS评分为(2.24±0.80)分,ODI评分为(29.17±2.50)分,JOA评分为(23.43±1.14)分,与术前比较差异均有统计学意义(t=14.842,P=0.006;t=36.927,P=0.002;t=–36.031,P=0.001)。31例患者均获随访,随访时间8~24个月,平均18.7个月。术后切口均Ⅰ期愈合,无手术并发症发生。随访期间复查腰椎X线片及CT显示椎弓根螺钉准确在位,无松动、断裂,椎间植骨融合良好。结论Quadrant系统微创通道下采用3D打印导航模块可以实现手术微创、少辐射及精准植钉目的。
