3D打印技术在骨肿瘤外科的现状与展望
|
摘要
<正>血清学骨肿瘤标志物、骨骼影像学技术(CT、MRI、E-CT、SPET-CT等)的发展使得骨肿瘤的早期诊断率不断提高,同时,新辅助化疗支持下的保肢治疗、免疫治疗、放射治疗、基因靶向治疗等的综合治疗策略,以及基于增材制造的3D打印技术的出现,使骨肿瘤的个体化治疗成为现实,显著提高了骨肿瘤患者的
3 D printing, known as an additive manufacturing, makes a reality that treatment for bone tumors could be personalized. This technology improves both the patients' functions and their living qualities. 3 D printing technology builds a complex geometric shape by adding materials layer by layer. Advantages in preoperative simulation, communication, and medical student education are shown. Personalized 3 D printing metal implants can be designed with different length, shape, and screw arrangements. Surgeons' ideas can be added such as effective support, immediate mechanical stability and osteointegration. It is a ultimate goal that cells, biomaterials and growth factors could be used to build human tissues or organs. 3 D printing will get rapid development in the future with the continuous improvement of the laws.
3 D printing, known as an additive manufacturing, makes a reality that treatment for bone tumors could be personalized. This technology improves both the patients' functions and their living qualities. 3 D printing technology builds a complex geometric shape by adding materials layer by layer. Advantages in preoperative simulation, communication, and medical student education are shown. Personalized 3 D printing metal implants can be designed with different length, shape, and screw arrangements. Surgeons' ideas can be added such as effective support, immediate mechanical stability and osteointegration. It is a ultimate goal that cells, biomaterials and growth factors could be used to build human tissues or organs. 3 D printing will get rapid development in the future with the continuous improvement of the laws.
引文
[1]王燎,戴戎.骨科个体化治疗与3D打印技术[J].医用生物力学,2014,29(3):193-199.
[2]Gillaspie EA,Matsumoto JS,Morris NE,et al.From 3-dimensional printing to 5-dimensional printing:enhancing thoracic surgical planning and resection of complex tumors[J].Ann Thorac Surg,2016,101(5):1958-1962.
[3]Wang YT,Yang XJ,Yan B,et al.Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders[J].Chin J Traumatol,2016,19(1):31-34.
[4]Zheng YX,Yu DF,Zhao JG,et al.3D printout models vs.3D-rendered images:which is better for preoperative planning[J]?J Surg Educ,2016,73(3):518-523.
[5]Chen X,Xu L,Wang W,et al.Computer-aided design and manufacturing of surgical templates and their clinical applications:a review[J].Expert Rev Med Devices,2016,13(9):853-864.
[6]Ma L,Zhou Y,Zhu Y,et al.3D printed personalized titanium plates improve clinical outcome in microwave ablation of bone tumors around the knee[J].Sci Rep,2017,7(1):7626.
[7]Guenette JP,Himes N,Giannopoulos AA,et al.Computer-based vertebral tumor cryoablation planning and procedure simulation involving two cases using MRI-visible 3D printing and advanced visualization[J].AJR Am J Roentgenol,2016,207(5):1128-1131.
[8]Ren X,Yang L,Duan XJ.Three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus:A case report[J].J Int Med Res,2017,45(1):372-380.
[9]Helguero CG,Kao I,Komatsu DE,et al.Improving the accuracy of wide resection of bone tumors and enhancing implant fit:A cadaveric study[J].J Orthop,2015,12(Suppl 2):S188-194.
[10]Xu N,Wei F,Liu X,et al.Reconstruction of the upper cervical spine using a personalized 3D-printed vertebral body in an adolescent with ewing sarcoma[J].Spine,2016,41(1):E50-54.
[11]Xiao JR,Huang WD,Yang XH,et al.En bloc resection of primary malignant bone tumor in the cervical spine based on 3-dimensional printing technology[J].Orthop Surg,2016,8(2):171-178.
[12]Wei R,Guo W,Ji T,et al.One-step reconstruction with a 3D-printed,custom-made prosthesis after total en bloc sacrectomy:a technical note[J].Eur Spine J,2017,26(7):1902-1909.
[13]Zhang Y,Wen L,Zhang J,et al.Three-dimensional printing and computer navigation assisted hemipelvectomy for en bloc resection of osteochondroma:A case report[J].Medicine(Baltimore),2017,96(12):e6414.
[14]Ma L,Zhou Y,Zhu Y,et al.3D-printed guiding templates for improved osteosarcoma resection[J].Sci Rep,2016,6:23335.
[15]Garcia-Tutor E,Romeo M,Chae MP,et al.3D volumetric modeling and microvascular reconstruction of irradiated lumbosacral defects after oncologic resection[J].Front Surg,2016,3:66.
[16]Wong KC,Kumta SM,Geel NV,et al.One-step reconstruction with a 3D-printed,biomechanically evaluated custom implant after complex pelvic tumor resection[J].Comput Aided Surg,2015,20(1):14-23.
[17]Kim D,Lim JY,Shim KW,et al.Sacral reconstruction with a 3D-printed implant after hemisacrectomy in a patient with sacral osteosarcoma:1-year follow-up result[J].Yonsei Med J,2017,58(2):453-457.
[18]Mobbs RJ,Coughlan M,Thompson R,et al.The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal pathologies:case report[J].J Neurosurg Spine,2017,26(4):513-518.
[19]Choy WJ,Mobbs RJ,Wilcox B,et al.Reconstruction of thoracic spine using a personalized 3D-printed vertebral body in adolescent with T9primary bone tumor[J].World Neurosurg,2017,105:1032.e13-17.
[20]Liang H,Ji T,Zhang Y,et al.Reconstruction with 3D-printed pelvic endoprostheses after resection of a pelvic tumour[J].Bone Joint J,2017,99-B(2):267-275.
[21]Lin CL,Fang JJ,Lin RM.Resection of giant invasive sacral schwannoma using image-based customized osteotomy tools[J].Eur Spine J,2016,25(12):4103-4107.
[22]Li J,Chen M,Fan X,et al.Recent advances in bioprinting techniques:approaches,applications and future prospects[J].J Transl Med,2016,14:271.
[23]Wang XF,Song Y,Liu YS,et al.Osteogenic differentiation of three-dimensional bioprinted constructs consisting of human adipose-derived stem cells in vitro and in vivo[J].PLo S One,2016,11(6):e0157214.
[2]Gillaspie EA,Matsumoto JS,Morris NE,et al.From 3-dimensional printing to 5-dimensional printing:enhancing thoracic surgical planning and resection of complex tumors[J].Ann Thorac Surg,2016,101(5):1958-1962.
[3]Wang YT,Yang XJ,Yan B,et al.Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders[J].Chin J Traumatol,2016,19(1):31-34.
[4]Zheng YX,Yu DF,Zhao JG,et al.3D printout models vs.3D-rendered images:which is better for preoperative planning[J]?J Surg Educ,2016,73(3):518-523.
[5]Chen X,Xu L,Wang W,et al.Computer-aided design and manufacturing of surgical templates and their clinical applications:a review[J].Expert Rev Med Devices,2016,13(9):853-864.
[6]Ma L,Zhou Y,Zhu Y,et al.3D printed personalized titanium plates improve clinical outcome in microwave ablation of bone tumors around the knee[J].Sci Rep,2017,7(1):7626.
[7]Guenette JP,Himes N,Giannopoulos AA,et al.Computer-based vertebral tumor cryoablation planning and procedure simulation involving two cases using MRI-visible 3D printing and advanced visualization[J].AJR Am J Roentgenol,2016,207(5):1128-1131.
[8]Ren X,Yang L,Duan XJ.Three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus:A case report[J].J Int Med Res,2017,45(1):372-380.
[9]Helguero CG,Kao I,Komatsu DE,et al.Improving the accuracy of wide resection of bone tumors and enhancing implant fit:A cadaveric study[J].J Orthop,2015,12(Suppl 2):S188-194.
[10]Xu N,Wei F,Liu X,et al.Reconstruction of the upper cervical spine using a personalized 3D-printed vertebral body in an adolescent with ewing sarcoma[J].Spine,2016,41(1):E50-54.
[11]Xiao JR,Huang WD,Yang XH,et al.En bloc resection of primary malignant bone tumor in the cervical spine based on 3-dimensional printing technology[J].Orthop Surg,2016,8(2):171-178.
[12]Wei R,Guo W,Ji T,et al.One-step reconstruction with a 3D-printed,custom-made prosthesis after total en bloc sacrectomy:a technical note[J].Eur Spine J,2017,26(7):1902-1909.
[13]Zhang Y,Wen L,Zhang J,et al.Three-dimensional printing and computer navigation assisted hemipelvectomy for en bloc resection of osteochondroma:A case report[J].Medicine(Baltimore),2017,96(12):e6414.
[14]Ma L,Zhou Y,Zhu Y,et al.3D-printed guiding templates for improved osteosarcoma resection[J].Sci Rep,2016,6:23335.
[15]Garcia-Tutor E,Romeo M,Chae MP,et al.3D volumetric modeling and microvascular reconstruction of irradiated lumbosacral defects after oncologic resection[J].Front Surg,2016,3:66.
[16]Wong KC,Kumta SM,Geel NV,et al.One-step reconstruction with a 3D-printed,biomechanically evaluated custom implant after complex pelvic tumor resection[J].Comput Aided Surg,2015,20(1):14-23.
[17]Kim D,Lim JY,Shim KW,et al.Sacral reconstruction with a 3D-printed implant after hemisacrectomy in a patient with sacral osteosarcoma:1-year follow-up result[J].Yonsei Med J,2017,58(2):453-457.
[18]Mobbs RJ,Coughlan M,Thompson R,et al.The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal pathologies:case report[J].J Neurosurg Spine,2017,26(4):513-518.
[19]Choy WJ,Mobbs RJ,Wilcox B,et al.Reconstruction of thoracic spine using a personalized 3D-printed vertebral body in adolescent with T9primary bone tumor[J].World Neurosurg,2017,105:1032.e13-17.
[20]Liang H,Ji T,Zhang Y,et al.Reconstruction with 3D-printed pelvic endoprostheses after resection of a pelvic tumour[J].Bone Joint J,2017,99-B(2):267-275.
[21]Lin CL,Fang JJ,Lin RM.Resection of giant invasive sacral schwannoma using image-based customized osteotomy tools[J].Eur Spine J,2016,25(12):4103-4107.
[22]Li J,Chen M,Fan X,et al.Recent advances in bioprinting techniques:approaches,applications and future prospects[J].J Transl Med,2016,14:271.
[23]Wang XF,Song Y,Liu YS,et al.Osteogenic differentiation of three-dimensional bioprinted constructs consisting of human adipose-derived stem cells in vitro and in vivo[J].PLo S One,2016,11(6):e0157214.