PurposeTo investigate the usefulness of three-dimensional (3D) printing in complex spinal surgery.MethodsThe study was conducted from October 2014 to March 2015 in Shenzhen Second Peoples' Hospital and 4 cases of complex severe spinal disorders were selected from our department. Among them one patient combined with congenital scoliosis, one with atlas neoplasm, one with atlantoaxial dislocation, and the rest one with atlantoaxial fracture-dislocation. The data of the diseased region was collected from computerized tomography scans for 3D digital reconstruction and rapid prototyping to prepare photosensitive resin models, which were applied in the treatment of these cases.ResultsThe use of 3D models reduced operating time and intraoperative blood loss as well as the risk of postoperative complications. Furthermore, no pedicle penetrations or screw misplacement occurred according to the postoperative planar radiographic images.ConclusionThe tactile models from 3D printing allow direct observation and measurement, helping the orthopedists to have accurate morphometric information to provide personalized surgical planning and better communication with the patient and coworkers. Moreover, the photosensitive resin models can also guide the actual surgery with the drilling of pedicle screws and safe resection of tumor.

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ObjectiveTo assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).Methods28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.ResultsThere is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).ConclusionPatients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.