3D打印导板引导骶髂螺钉置钉实验与临床准确性评价

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Abstract Objective To evaluate the accuracy of sacroiliac screw placement assisted by a individualized three-dimensional (3D) printing guide template in pelvic specimen experiment and clinical application.Methods (1) Eight cadaveric pelvic specimens were used in this experiment.Data of thin layer CT scanning of the specimens were imported into Mimics 19.0 software in DICOM format to establish 3D digital models of pelvis.With the posterior superior iliac spine as the anchor point，the sacroiliac joint screw placement navigation template was designed，and six hollow screws were inserted into each specimen.The position of the screw in the sacral vertebra was observed by X-ray examination，CT scan and specimen dissection.(2)From June 2017 to December 2020，12 cases of posterior pelvic ring injury with sacroiliac screw fixation guided by 3D-printed Novel navigation template were retrospectively analyzed.There were 10 males and 2 females.The average age was (35.75±11.58) years，ranging from 19 to 62 years.The position of sacroiliac screw in the sacral vertebra was evaluated by X-ray examination and CT scan after surgery.Results (1) A total of 16 sacroiliac joint screw placement navigation templates were used in the experiment and 48 screws were inserted on both sides.According to Smith's evaluation standard，45 screws were inserted at grade 0 with an accuracy of 93.75%.3 screws penetrated through the sacral vertebral cortex，including 2 screws at grade Ⅰ and 1 screw at grade Ⅱ.(2) A total of 26 sacroiliac screws were inserted in 12 patients with posterior pelvic ring injury，25 of which were completely located in the sacral vertebra.These patients rated as level 0 with an accuracy rate of 96.15%.In only 1 patient，the screw passed out of the sacral vertebral cortex and entered the sacral canal.This cased rated as grade Ⅰ(3.85%)，but had no neurological symptoms.According to Matta scoring，10 cases were excellent and 2 cases were good.The last follow-up was based on Majeed’s functional scoring standard.It was excellent in 8 cases and good in 4 cases.Conclusion The screw placement of sacroiliac joint guided by 3D printed navigation templates is accurate and safe.The clinical curative effect is excellent，the operation is simple，the equipment requirements are low，and it is convenient for the primary hospital to popularize.

Key words： 3D printing technology novel navigation template sacroiliac screws posterior pelvic ring injury accuracy

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	Articles by authors
	You Murong
	Dong Shuhui
	Fan Zhiqiang
	Ye Haimin
	Dong Xieping
	Zou Huachun

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You Murong,Dong Shuhui,Fan Zhiqiang, et al. Experimental and Clinical Accuracy Evaluation of Sacroiliac Screws Placement Guided By 3D Printing Navigation Template[J]. sygkzz, 2023, 29(2): 121-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I2/121

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