最近出版的一个值3D打印优惠用于复杂犬手术的手术计划案例系列in3D医学印刷。我家黄博士和斯蒂芬妮Goldschmidt年代hare how the collaboration between radiology and veterinarian medicine was fostered through the care of Dr. Huang’s own dog, Chubbs.
During Dr. Huang’s clinical anaplastology training, she assisted in virtual surgical planning and 3D printing of patient specific anatomical models and surgical guides for craniofacial surgeons. Dr. Huang saw first-hand how the technology could be utilized to enhance personalized medicine and improve patient outcome. When Dr. Huang’s 9-year-old English bulldog, Chubbs, was diagnosed with maxillary chondroblastic osteosarcoma, she thought to do the same for Chubbs.
在从Stephanie Goldschmidt博士那里获得了Chubbs的对比度增强了计算机断层扫描（CT）后，Huang博士能够使用3D系统DICOM（D2P）（D2P）（一种FDA清除的分割软件）来分割其头骨和肿瘤。她首先使用她的Formlabs Form 3B打印机用肿瘤印刷了头骨via增值税光聚合技术。To facilitate anatomical and tumor visualization, she hand-painted the tumor red while referencing his CT data.Thanks to the collaborative generosity of the Minneapolis VA Minneapolis Adaptive Design & Engineering Program (MADE), Chubbs’ skull was also printed using a Stratasys J750 with material jetting technology which allowed for the skull and tumor to be printed in white and magenta, respectively.
Through Chubbs, a meaningful collaboration was fostered.
Goldschmidt博士对3D印刷模型的肿瘤程度的可视化和触觉评估得出的结论是，具有2 cm边缘的治疗意图手术将带来高潜在发病率的高风险。因此，选择以保守的边缘（0.5-1 cm）对肿瘤进行切除，并使用术后放射疗法治疗以最大程度地减少潜在并发症。Chubbs在手术和辅助放射疗法后一年多了，表现出色。
通过Chubbs，培养了有意义的合作，黄博士能够为Goldschmidt博士提供3D打印解剖模型和生物相容性手术指南，用于其他复杂的犬类口腔和上颌骨手术。
The next patient was an 8-year-old male Boston terrier with plasma cell tumor, causing osteolysis of his rostral mandible, requiring surgical reconstruction. Using his preoperative cone beam CT (CBCT), Dr. Huang was able to segment and print his skullvia增值税光聚合。The 3D printed skull model was utilized for preoperative planning and served as an intraoperative reference for bilateral rostral mandibulectomy and pre-contouring of the titanium plate for mandibular reconstruction. By allowing pre-contouring of the titanium plate, the printed model was estimated to decrease surgical time by approximately 30 minutes. As of 4 months post-op, the Boston terrier is doing well with bony consolidation demonstrated on his follow-up CBCT.
我们在病例系列中描述的最终患者是一名6个月大的雄性拉布拉多猎犬，他的运动范围严重减少了继发于复发性颞关节（TMJ）链球菌后肌肉置换术后的颞下颌关节（TMJ）。关节强硬症是继发于8周大的狗咬伤的继发的。由于运动范围逐渐减少，创伤后10周进行初始间隙关节置换术。初次手术后大约3个月，运动范围开始逐渐减少，CBCT证实，存在新的骨形成，随后是链链球菌。
随着3D打印技术的继续发展，兽医医学的采用将增加
Due to the increased complexity of the surgery, anatomical models and surgical guides were designed and fabricatedvia增值税光聚合。颅骨模型是用白色树脂印刷的，并在生物相容性手术指南树脂中制造了手术指南。将3D打印的头骨和手术指南灭菌，以作为术中置换术和骨关节置换术和截骨术的指导。据估计，3D打印的型号和指南可以通过允许外科医生和受训者对病变的触觉欣赏，从而节省了一个小时的手术和麻醉时间，因此更有信心在非常高风险的位置运行。
Since the publication of our case series, we have continued to utilize 3D printing to assist in the clinical care of both veterinary and human patients. 3D printed models can improve preoperative planning and intraoperative guidance while enhancing healthcare/veterinary training and patient/pet owner communication. As 3D printing technology continues to advance, there will be increased adoption in veterinary medicine as it is already evidenced in human medicine with more hospitals offering medical 3D printing. We aim to continually refine, validate, and improve our workflow while collecting more outcome-based evidence on the utilization of medical 3D printing for our patients with complex needs.
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