【摘要】 目的 通过数字化骨科技术制作出个体化导向模板，在导板引导下在下颈椎实物模型上置入椎弓根螺钉，并比较其与传统徒手置钉方法在置钉准确率方面的区别。方法 随机选取芜湖市第二人民医院2021年1月至2021年12月住院行颈椎CT三维重建的患者CT资料30例，通过Mimics软件进行三维重建，模拟椎弓根螺钉置钉，设计出最佳进针钉道。继而通过逆向工程软件提取设计出个体化反向模板，3D打印制作出椎体模型及带钉道的导向模板。在C₃-C₆椎体模型上采用随机数字法随机于一侧应用导向模板辅助置入椎弓根螺钉（导向模板组），另一侧徒手置钉（徒手置钉组），检查并比较两组的置钉准确率。结果 所有颈椎椎体模型双侧均顺利完成置钉，共240枚螺钉。导向模板组116枚螺钉（96.7%）位置为Ⅰ级，4枚螺钉（3.3%）为Ⅱ级，而徒手置钉组73枚螺钉位置为Ⅰ级（60.8%）,17枚螺钉（14.1%）为Ⅱ级，11枚螺钉（9.2%）为Ⅲ级，19枚螺钉Ⅳ级（15.8%），两组比较差异有统计学意义（P<0.05）。结论 通过计算机辅助软件与3D打印机制作出个体化导向模板，在导板引导下在实物模型上成功完成置钉，置钉准确率较徒手置钉方法有显著优势，具有较好的临床应用前景。更多还原

【Abstract】 Objective To create a personalized guide template through digital orthopedic technology, and insert pedicle screws on the lower cervical physical model under the guide of the guide plate, and compare the difference between the method and the traditional manual screw placement method in the accuracy of screw placement. Methods The CT data of 30 patients hospitalized in Wuhu Second People’s Hospital from January 2021 to December 2021 who underwent 3D reconstruction of cervical spine CT were randomly selected. The 3D reconstruction was performed by using the Mimics software to simulate the pedicle screw placement, and the optimal approach was designed. Then the individualized reverse template was extracted and designed by reverse engineering software, and the vertebral body model and the guide template with nail path were produced by 3D printing. On the C₃-C₆ vertebral body model, the random number method was used to randomly place pedicle screws on one side（group A） with the aid of guide templates, and the screws on the other side（group B） with bare hands. The accuracy of screw placement was checked and compared between the two groups. Results All cervical vertebrae models successfully completed bilateral screw placement, a total of 240 screws. In group A, 116screws（96.7%） were Grade Ⅰ, and 4 screws（3.3%） were Grade Ⅱ. In group B, the position of 73 screws was Grade Ⅰ（60.8%）, 17 screws（14.1%） were Grade Ⅱ, 11 screws（9.2%） were Grade Ⅲ, and 19 screws（15.8%） were Grade Ⅳ, with significant difference between the two groups（P<0.05）. Conclusion In this study, the individualized guide template was created by computer-assisted software and 3D printer, and the nail placement was successfully completed on the physical model under the guidance of the guide plate. The accuracy rate of the nail placement was significantly superior to that of the manual nail placement method, which has a good prospect of clinical application.更多还原