Computer simulation combined with 3D printed spine surgery

  On July 15, Ma Xuexiao, deputy director of spine surgery, led a team under the guidance of Chen Bohua, director of the Orthopedic Center, to successfully perform the first computer simulation combined with 3D printing spine surgery in China, successfully completing a posterior cervical spine revision for a patient with recurrent cervical spinal stenosis, marking our orthopedic department officially entered the era of precision surgery.  Since then, the team has applied this technology to complete many other surgeries such as difficult scoliosis orthopedics and thoracic spine malignant tumor resection, all of which have achieved good results. Many media such as Health News, Qingdao Daily, Qingdao Evening News, Al Jazeera, Qilu TV, Qingdao TV and so on have reported on this, which added glory to the “Year of Innovation” of our hospital.  According to the introduction, the basic process of computer simulation combined with 3D printing spine surgery is: using MIMICS software to acquire and process the patient’s 3D CT data of the spine, create a 3D reconstruction model of the spine in the computer; three-dimensional, accurate display of the lesion and surrounding tissue, according to which the surgical plan is designed, the surgical approach, the scope of resection, intraoperative precautions, and so on, and complete the virtual surgery on the 3D reconstruction model. .  Then, using 3D printing technology, a full simulation model of the patient’s spine and spinal cord is printed in equal scale, and a detailed surgical rehearsal is performed on the model to verify the feasibility of the design plan and repeatedly simulate the surgical operation, so that the patient can be operated precisely and quickly.  This type of surgery can establish individualized 3D virtual model and 3D solid model for each patient, which enables doctors to clearly, intuitively and comprehensively understand the lesion and the adjacent relationship with the surrounding tissues before surgery, and carefully formulate an individualized surgical plan to suit the patient’s reality, and can conduct simulation exercises, thus effectively avoiding the risk of spinal cord nerve injury and paraplegia and improving the surgical results.  It is understood that many surgical cases have confirmed that due to adequate preoperative preparation and precise intraoperative positioning, surgical trauma is greatly reduced, intraoperative bleeding is reduced, and surgical time is shortened. The patient recovered quickly after the surgery, and the position of the internal fixation nail bar and the direction and length of the screw implantation were perfectly matched with the preoperative 3D printing simulation, and the spinal deformity was satisfactorily corrected and the spinal stability was perfectly rebuilt, and the long-term results of the patient were guaranteed.  In addition, doctors can also use 3D printing models to let patients understand their own conditions and surgical planning visually before surgery, which improves the effect of doctor-patient communication and enhances patient cooperation. At the same time, 3D printing also brings gospel for clinical teaching work, which can make medical students receive more effective surgical training and improve the quality of practical teaching.  It is reported that the MIMICS software-assisted surgical design used in the surgery is one of the main focuses of Ma Xuexiao’s postdoctoral research during her stay in the United States, and is also a key research project of our National Key Clinical Specialties Orthopedics Department and Shandong Orthopedic Trauma Institute. Currently, the team is working to integrate the MIMICS system and 3D printing technology together into the orthopedic module of Higemi Medical Image Reconstruction and Surgery Simulation System jointly developed by our hospital and Hisense Group for the further benefit of our patients.