The Application Of Digital Three-dimensional Reconstruction And Rapid Prototyping Technology In The Kyphosis Orthopedics

Objective:To investigate the clinical application value of digital three-dimensionalreconstruction and rapid prototyping technology in the kyphosis orthopedics and providescientific basis for individual ideal operation programs of severe kyphosis.Methods:24kyphosis patients including10males and14females with averageage of41.4years old(from21to60years old),who were treated from January2008toDecember2012in our hospital,were retrospectively reviewed. This group of cases wereroutinly preoperative X-ray, CT, MRI imagined,3D was made image and physical modelby digital three-dimensional reconstruction and rapid prototyping,which assistantedoperation design and simulating operation,finally optimal operation programs were chosenand operation was guided by the physical model during operation.The correction ofpostoperative kyphosis and sagittal vertical axis(SVA) were observed.The Frankel gradingsystem for nerve function of lower limbs,the visual analogue scale(VAS)for pain level,wereapplied before operation and follow-up．Results:The intraoperative findings of spine morphology and the three-dimensionalmodel of preoperative production basic conform to.All operations were successfullycompleted as planned.The orthopedic and the position of the pedicle screw weresatisfying,and only one case experienced temporary nerve damage,without permanentspinal cord, nerve root and vascular injury and other complications.The average follow-uptime was25.1months (from11months to47months).The mean Cobb angle preoperative,1week and the final follow-up after operation was60.3°,13.3°and16.4°respectively,with anaverage corrective rate of72.8％.The SVA of patients increased from7preoperation to14.The average VAS score from6.1preoperation decreased to2.1postoperation. The patients of Frankel grade E increased from16preoperation to21of the finalfollow-up,grade D decreased from5to2,grade C decreased from3to1.Conclusion:Digital three-dimensional reconstruction and rapid prototypingtechnology which can clearly display the anatomical structure of the kyphosis, improve thepreoperative diagnostic rate,assist in preoperative evaluation and surgical proceduredesigning,and simulate operation,is a good guidance for the operation orthopedic andinternal fixation operation.