"What did Dr. Xiao Sun say, he is still in the capital, right?" Professor Zhu Minhua looked at Yuan Ping'an and hung up the phone, stunned and speechless, a little strange. "Or is he already back in Ningyuan?"

Yuan Ping'an swallowed and foamed," he said...... He was right next to the patient. ”

"Patient?" Zhu Minhua looked surprised, "What patient? is he in the emergency room?" He turned his head to look at Li Songzhao and Lu Xuexin who were lying on the hospital bed.

"He was by Song Hualin's side. It's the patient who is going to have vertebral body replacement. Yuan Ping'an shook his head, the stunned look on his face gradually subsided, replaced by shock. According to Dr. Sun, he was right next to the overturned bus. ”

Zhu Minhua frowned, "This guy, I really don't know if he's lucky or a little bit back." Without going to delve into the problem of Sun Lien's appearance at the scene of the accident, Zhu Minhua said to Yuan Ping'an, "You go to the orthopedic department first, see the printed vertebral body, and I will pick up the car later." You go into the operating room with the prosthesis. ”

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3D printing technology is becoming a hot topic of discussion in all departments of the hospital. This is especially the case in orthopedics. Before the maturity of laser metal 3D printing technology, orthopedic departments, especially spine surgery, began to use CT imaging and resin 3D printing technology for preoperative preparation and drills. The surgeons in the orthopedic department will choose to print out the patient's vertebral body model through 3D printing technology, and then pre-rehearse the model.

Orthopedic surgeons need to have very good spatial imagination so that they can mentally construct what the patient's bones and joints should look like in countless plain scans. Once such a model is built, doctors are able to plan and design surgeries. Especially in the sensitive and important structure of the human body such as the vertebral body, doctors have to repeatedly deliberate before deciding what kind of surgical plan to use.

However, no matter how experienced you are, it is possible to make assumptions based on CT or MRI images alone. Doctors are human beings, and even if thousands of corresponding surgeries have been performed, no one can guarantee that the doctor's judgment will not go wrong next time. After all, the vertebral body is complex, and the doctor's energy and concentration may be weakened when seeing a large number of patients. If it is discovered during the procedure that the patient's bones are in a different condition than expected, it is likely to lead to serious consequences.

Therefore, 3D printing technology has become popular in the orthopedics of various top hospitals. In particular, departments involving the cervical, thoracic, and lumbar spine, as well as joint surgery. As long as the patient's condition is not particularly critical, doctors are always willing to spend a little more time printing out a model of the affected area, and then the whole department will discuss the surgical plan together.

However, if it is just a model, the benefits to patients are relatively limited. Indeed, having a model can allow doctors to have a more comprehensive grasp of the situation, shorten the operation time, reduce the surgical trauma, and enhance the surgical effect. But at the end of the day, it's just an aid for doctors. However, the advent of metal 3D printing technology has made it possible for the first time to "privateize" replacement parts.

The vertebral fixes that are commonly seen on the market today are basically general-purpose models. Whereas, the spine of the human body is made up of three parts, and there are three physiological curvatures that naturally exist. As a result, each vertebral body has a completely different shape. Although the universal fixation body is easy to manufacture, there are countless problems in practical use. Too long or too short is a minor problem - the orthopedic surgeon has an electric grinder and a chainsaw, and it is really impossible to modify the fixation with tools. But the real trouble lies in the cervical spine, especially when it comes to the C1 to C4 cervical spine. The cervical vertebrae of the C1 and C2 segments are the atlas and the pivotal vertebrae. Both vertebral bodies are short in length and complex in shape. In addition to connecting and supporting the rotation of the skull, it is also necessary to ensure that the medulla oblongata and spine in the spinal canal are not compressed.

Before the advent of 3D metal printing technology, if the patient had a severe fracture of the atlantoaxial vertebrae, or suffered from occipital chordoma. Then the doctors can only use screws and stents to screw the cut medical titanium mesh on the anterior and posterior sides of the damaged and fragile atlantoaxial vertebrae, and then pray that they have completely cleaned the tumor, and pray that the patient will not have screws or stents loose in the future life.

If the stent is loose, it may cause the hard titanium mesh to deform, which can squeeze into the patient's esophagus, trachea, and even carotid artery. If you don't come to the hospital for re-examination often, this deformation is likely to kill the patient. Once the tumor recurs, the new tumor is likely to continue to erode the remaining atlantoaxial vertebrae. Even with the support of titanium mesh, without the vertebral body, the nerves and blood vessels are not supported and protected, and the patient will still die.

The caudal medulla oblongata is an extension of the cerebellum and the starting point of the spine. It mainly regulates and controls the body's heartbeat, blood pressure, breathing, digestion and other important functions, once the slightest injury, the patient will die directly, and there is no chance of rescue. For this reason, this area is often referred to as the "Life Exclusion Zone". Doctors who perform surgeries rarely consider surgery here as long as they have a choice – the risks are too great.

However, Song Hualin's situation is more special. After the emergency doctor of Tongxie inquired about his information in the case bank, he quickly called several orthopedic leaders for consultation, these are all industry leaders who can write teaching materials and formulate diagnosis and treatment guidelines. And these experts, after reading Song Hualin's imaging examination data and surgical records fifteen years ago, all frowned.

In fact, the person who operated on Song Hualin back then was also the top person in the orthopedics department of Tongxie. For the same chordoma removal, doctors in other hospitals may consider directly performing a hemisotomy of the pivotal vertebrae, but Tongxie's surgical plan is to remove the eroded vertebra through spinal endoscopy and electro-grinding when the chordoma is removed, and fill it with bone cement.

Thanks to this surgical plan, Song Hualin's axial vertebrae were removed from nearly 30% of the bone, but it still maintained its strength to a certain extent. If it weren't for this surgical plan, when the bus overturned, Song Hualin would probably have died on the spot.

"It can only be replaced. Academician Qiu, director of the Department of Orthopedics of Tongxie, was silent for a long time and put forward his own views. "Although it is not known the current fracture status of the patient, it is unrealistic to internally fix the pivotal vertebrae that have been worn off by 30%. He turned his head to look at his students, and Professor Wang Yifei, the current deputy director of the Department of Orthopedics, asked, "How is the 3D printing technology you are doing?

"The phase II clinical trial is not over yet. Professor Wang replied, "But our 3D printing is mainly for hip and pelvic repair. Directly superior to the ...... vertebrae"

"I remember that Southern Medicine was doing this research. Academician Qiu took out the phone, "You first sort out the original video data, and I'll ask the old friends over there if you can make a drawing." ”

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Sun Lien took an ambulance, and it didn't take long for him to come to the emergency department of Tongxie. The place where the accident occurred at the high speed is only 18 kilometers away from here, although the level of the driver who drove the ambulance this time is obviously not as good as the "Brother Wang" last night, but the speed is still fast and scary. In addition, there were police motorcycles to open the way, and the ambulance ran the red light continuously along the way, and rushed to the hospital as fast as possible.

"Quick, send to the rescue room!" Professor Zhu had already led someone to guard the door waiting to pick up the car, and 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 go into the operating room with me in a while." ”

Xia Hai looked at Sun Lien with a dissatisfied face, "If you are a doctor of the Tongxie, you will say that you are from the Tongxie! What are you doing pretending to be a foreign doctor? I won't eat you again!"

Sun Lien didn't have time to talk to this poor doctor, put on a white coat, pushed the hospital bed and rushed into the emergency room. But Song Hualin was still muttering on the bed, "You don't need to push it so fast, there is still time." ”

Song Hualin's vital signs are stable, although there is an element of luck, but it is also inseparable from Sun Lien's emergency treatment. Sun Lien pushed the bed into the rescue room, and after reporting the situation to the doctors with serious faces in the association, he was a little relieved.

"Why did you run to the highway?" Seeing that he was done with business, on the way to take Song Hualin for an imaging examination, Professor Zhu Minhua finally couldn't help but ask, "Aren't you here to pick up people?"

"It's a pick-up. Sun Lien replied with a wry smile, "I'm going to pick up Dr. Pascal's family from Hopkins." As a result, as soon as I received someone and walked back, I encountered this car accident. In addition to Professor Pascal and me, there were also Rachel and my colleague Hu Jia, who came to the association to do an international exchange program. They're busy enough, too. ”

Zhu Minhua's eyes changed a little when he looked at Song Hualin, "I really don't know if this patient is lucky or unlucky." Let's be lucky, a car accident hurt the pivotal spine, let's say unlucky, but I met you again. ”

Sun Lien didn't answer, he changed the topic, "I heard Dr. Yuan say that Tongxie plans to use a 3D printed prosthesis to do a pivotal spine replacement for him?"

"It depends on the condition of his fractures. Zhu Minhua nodded, "Ping'an told you on the phone, right? This patient has had chordoma dissection with us before." Looking at the CT results, if it is a type 1 fracture, then it will definitely have to be replaced. ”

"I didn't know that the technology was going to be able to do that yet. Sun Lien was a little speechless, "The shape of the pivot vertebrae is complex, and the requirements for strength are also very high, right?"

"If it was the previous resin or plastic print, it would definitely not work. Zhu Minhua also sighed with emotion, "As a doctor, you must be grateful for the progress of technology." Twenty years ago, no matter who was in charge of the operation, this operation was no different from murder. But now, at least we can fight for the patients. ”

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