"What did Dr. Xiao Sun say? Is he still in the capital?" Professor Zhu Minhua watched Yuan Pingan hang up the phone and remained silent, which was a little strange. "Or is it that he has returned to Ningyuan?"
Yuan Pingan swallowed and said, "He said... he was right next to the patient."
"Patient?" Zhu Minhua looked surprised, "What patient? Is he in the emergency room?" He turned to look at Li Songzhao and Lu Xuexin who were lying on the hospital bed.
"He is next to Song Hualin. He is the patient who is going to undergo vertebral body replacement surgery." Yuan Pingan shook his head, and the blankness on his face gradually faded away, replaced by shock. "According to Dr. Sun, he was in that overturned car.
Next to the bus.”
Zhu Minhua frowned, "This guy, I really don't know whether he was lucky or just a bad luck." Without delving into the issue of Sun Lien's appearance at the accident scene, Zhu Minhua said to Yuan Pingan, "Go to the orthopedics department first and take a look.
The printed vertebral body condition, I will pick you up later. You follow the prosthesis into the operating room."
3D printing technology is becoming a hot topic of discussion in all departments in the hospital. This discussion is particularly intense in the orthopedics department. Before the maturity of laser metal 3D printing technology, the orthopedic department, especially the spine surgery department, began to use CT imaging and resin 3D printing.
Printing technology has been used for preoperative preparation and practice. Orthopedic surgeons will choose to use 3D printing technology to print out the patient's vertebral model first, and then conduct pre-practices on the model.
Orthopedic surgeons need to have very good spatial imagination so that they can build in their minds what the patient's bones and joints should look like from countless plain film scans. Only after building such a model can doctors have
The ability to plan and design surgeries. Especially for sensitive and important human structures such as the vertebral body, doctors have to deliberate over and over again before deciding on the final surgical plan.
However, no matter how experienced you are, you may make mistakes when making assumptions based only on CT or MRI images. Doctors are also human beings. Even if they have performed thousands of corresponding surgeries, no one can guarantee that the doctor’s judgment will not be wrong next time.
Problem. After all, the shape of the vertebral body is complex, and when seeing a large number of patients, the doctor's energy and attention may be weakened. If it is discovered during the operation that the condition of the patient's bones is different from expected, it is likely to lead to
Serious consequences.
Therefore, 3D printing technology has become popular in the orthopedics departments of various top hospitals. Especially departments involving cervical spine, thoracic spine, lumbar spine, and joint surgery. As long as the patient's condition is not particularly critical, doctors are always willing to spend a little more time.
A model of the affected area is printed out, and then the entire department discusses the surgical plan together.
However, if it is just a model, the benefits to patients are actually relatively limited. Indeed, having models can allow doctors to have a more comprehensive grasp of the situation, shorten operation time, reduce surgical trauma, and enhance surgical effects. But in the final analysis, it is only an assistant to doctors.
It's just a tool. But the emergence of metal 3D printing technology has made "private" replacement parts possible for the first time.
Most surgical vertebral body fixators on the market today are basically universal models. The human spine is composed of three parts, and there are three natural physiological curvatures. This also results in the shape of each vertebral body being completely different.
Although general-purpose fixed bodies are easy to manufacture, there are countless troubles in actual use. Too long or too short are considered minor problems. Orthopedic surgeons have electric grinders and electric saws at their disposal. If this is not possible, they can use tools to cut the fixed bodies.
Make modifications. But the real trouble lies in the cervical vertebrae, especially when it comes to the cervical vertebrae c1 to c4. The cervical vertebrae c1 and c2 are the atlas and axis. The length of these two vertebrae is very short and the shape is complex. In addition to the connection
In addition to supporting the rotation of the skull, it must also ensure that the medulla oblongata and spine in the spinal canal are not squeezed.
Before the advent of 3D metal printing technology, if a patient suffered a severe atlantoaxial fracture or suffered from an occipital chordoma, doctors could only use screws and brackets to twist the cut medical titanium mesh during surgery.
On the front and back sides of the damaged and fragile atlanto-axial vertebrae, and then pray that the tumor has been completely removed, and that the patient will not have loose screws or brackets in his future life.
A loose stent may cause the hard titanium mesh to deform, squeezing the patient's esophagus, trachea, and even carotid arteries. If the hospital is not visited frequently for review, this deformation may directly kill the patient.
Once the tumor recurs, the new tumors are likely to continue to erode the remaining atlantoaxial vertebral bodies. Even with the support of titanium mesh, without the vertebral bodies, the nerves and blood vessels will not be supported and protected, and the patient will still die.
The tail end of the medulla oblongata is an extension of the cerebellum and the starting point of the spine. It mainly regulates and controls the human body's heartbeat, blood pressure, breathing, digestion and other important functions. Once slightly damaged, the patient will die directly without even a chance for rescue.
Therefore, this area is often called the "life forbidden zone". As long as the surgeons have a choice, they will basically not consider that the risk of surgery here is too great.
However, Song Hualin's situation is quite special. After the emergency doctors of Tongxie looked up his information in the case database, they quickly called in several big guys from the Department of Orthopedics for consultation. They are all industry leaders who can write teaching materials and formulate diagnosis and treatment guidelines.
Character. These experts all frowned after looking at Song Hualin's imaging examination data and surgical records from fifteen years ago.
In fact, the person who performed the surgery on Song Hualin back then was also a top figure in Tongxie Orthopedics. For the same purpose of clearing out chordoma, doctors from other hospitals might consider doing a direct hemisection of the spinal vertebrae, but Tongxie’s surgical plan was to clear out the chordoma.
When the tumor was detected, the eroded axis was removed through spinal endoscopy and electrolysis, and filled with bone cement.
Thanks to this surgical plan, although nearly 30% of the bone in Song Hualin's axis was removed, it still maintained its strength to a certain extent. If not for this surgical plan, Song Hualin would have probably died when the bus overturned.
On the spot.
"It can only be replaced." Academician Qiu, director of the Department of Orthopedics of Tongxie, put forward his opinion after a long silence. "Although I don't know the patient's current fracture situation, it is not necessary to internally fix the axis that has been worn away by 30%.
Reality." He turned to look at his students, Professor Wang Yifei, now the deputy director of the Department of Orthopedics, and asked, "How is the 3D printing technology you developed? Can it be used?"
"The second phase of clinical trials is not over yet." Professor Wang replied, "But our 3D printing is mainly used for repairing hip joints and pelvises. It goes directly to the axis..."
"I remember that Southern Medical University is doing this research." Academician Qiu took out the phone, "You guys sort out the original imaging data first, and I'll ask my old friends over there if they can make a drawing."
Sun Lien sat in the ambulance, and it didn't take long before he arrived at the Tongxie Emergency Department. The place where the accident occurred on the highway was only 18 kilometers away from here. Although the driver who drove the ambulance this time was obviously not as good as the "Brother Wang" last night,
But the speed was still frighteningly fast. In addition, there were police motorcycles clearing the way, and the ambulance rushed through red lights continuously along the way and rushed to the hospital as quickly as possible.
"Quickly, send to the emergency room!" Professor Zhu had already led people to wait at the door to pick up the car. When he saw Sun Lien getting out of the car with the rescue bed, he directly threw the white coat in his hand over, "Put it on.
You will come into the operating room with me later."
Xia Hai looked at Sun Lien with a look of dissatisfaction on his face, "You are a doctor from Tongxie, just say you are from Tongxie! Why are you pretending to be a doctor from other places? I won't eat you!"
Sun Lien didn't have time to talk to this talkative doctor, so he put on his white coat, pushed the hospital bed and rushed into the emergency room. But Song Hualin was still mumbling on the bed, "No need to push so fast, there is still time."
Song Hualin's vital signs were stable. Although this was a matter of luck, it was also inseparable from Sun Lien's emergency treatment. Sun Lien pushed the bed into the emergency room, and after reporting the situation to the serious-looking doctors in the association, he spoke for a moment.
He breathed a sigh of relief.
"Why did you run to the highway?" Seeing that the business was done, and on the way to take Song Hualin for imaging examination, Professor Zhu Minhua finally couldn't help but ask, "Aren't you here to pick someone up?"
"It's to pick up people." Sun Lien responded with a wry smile, "I was going to pick up Dr. Pascal's family from Hopkins. But when I was walking back after picking up people, I encountered this car accident. I was in the car at the time.
In addition to Professor Pascal and me, there are also Rachel, who is here to work with us on an international exchange project, and my colleague Hu Jia. They are also very busy."
Zhu Minhua's eyes changed when he looked at Song Hualin, "I really don't know whether this patient is lucky or unlucky. I would say he was lucky because he injured his axis in a car accident. I would say he was unlucky to meet you again."
Sun Lien didn't answer, so he changed the topic, "I heard from Dr. Yuan that Tongxie plans to use 3D printed prostheses to perform a spinal replacement surgery on him?"
"The details will depend on his fracture condition." Zhu Minhua nodded, "Did Ping An tell you on the phone? This patient has had chordoma dissection done here before. Look at the CT examination results, if
If you have a type 1 fracture, you will definitely need to have it replaced."
"I didn't know that the current technology could achieve this step." Sun Lien was a little surprised, "The shape of the axis is complex, and the strength requirements are also very high, right?"
"If it were resin or plastic printing in the past, it would definitely not work." Zhu Minhua also sighed, "When you are a doctor, you must be grateful for the advancement of technology. Twenty years ago, no matter who was doing the surgery
, this operation is no different from killing someone. But now, at least we can fight for the patient."