胸腰椎骨折椎弓根螺钉置入术中采用3D打印技术的价值分析
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摘要
目的探究胸腰椎骨折椎弓根螺钉置入术中采用3D打印技术的价值。方法选取胸腰椎骨折患者82例为研究对象,随机分为观察组和对照组,各41例。两组患者均采用椎弓根螺钉置入术治疗,对照组采用常规椎弓根螺钉置入术,观察组采用3D打印技术重建1∶1仿真椎体模型,对手术方案进行优化并演练。观察比较两组患者术中指标、置钉准确率、术后并发症以及术前、术后1个月和术后6个月的腰椎JOA评分情况。结果观察组手术时间短于对照组,术中照射X线次数及出血量均少于对照组,置钉准确率高于对照组,均有显著差异(P<0.01);两组治疗后,伤椎前后高度比均较治疗前提高,Cobb角均较治疗前降低;两组术后1个月腰椎JOA评分均较术前提高,术后6个月腰椎JOA评分均较术前1个月提高(P<0.01)。两组治疗前后伤椎前后高度比、Cobb角以及腰椎JOA评分比较,均无显著差异(P>0.05)。结论对胸腰椎骨折行椎弓根螺钉置入术患者应用3D打印技术,可以明显提高置钉的准确率,减少术中出血量及X线照射次数,值得临床推广应用。
Objective To explore the value of 3 D printing technique in pedicle screw placement for thoracolumbar fracture.Methods Eighty-two cases of thoracolumbar fracture were randomly divided into two groups,41 cases in each group.The control group received conventional pedicle screw implantation,while the observation group did 3 D printing technique to reconstruct the model of 1∶1 simulation vertebral body,and the operation scheme was optimized and practiced.The data including the operative indexes,screw placement accuracy,complications and the JOA scores of lumbar spine of postoperative 1 month and 6 months,were compared between the two groups.Results In the observation group,the operation time,the number of X-ray irradiation and the amount of bleeding lessen compared with the control group,and the accuracy of nail placement was significantly higher than that of the control group(P<0.01).After treatment,the ratio of anterior and posterior height of injured vertebrae was higher and the angle of Cobb was lower than that before treatment,the JOA score of lumbar vertebrae was higher than that before treatment,and the JOA score of lumbar vertebrae at 6 months after operation was higher than that before treatment in both groups(P<0.01).There was no significant difference in the ratio of anterior and posterior vertebral height,Cobb angle and lumbar JOA score between the two groups before and after treatment(P>0.05).Conclusion 3 D printing technique improved the accuracy of pedicle screw placement for thoracolumbar fracture and reduced the number of fluoroscopy and bleeding amount,which is worthy of clinical application.
Objective To explore the value of 3 D printing technique in pedicle screw placement for thoracolumbar fracture.Methods Eighty-two cases of thoracolumbar fracture were randomly divided into two groups,41 cases in each group.The control group received conventional pedicle screw implantation,while the observation group did 3 D printing technique to reconstruct the model of 1∶1 simulation vertebral body,and the operation scheme was optimized and practiced.The data including the operative indexes,screw placement accuracy,complications and the JOA scores of lumbar spine of postoperative 1 month and 6 months,were compared between the two groups.Results In the observation group,the operation time,the number of X-ray irradiation and the amount of bleeding lessen compared with the control group,and the accuracy of nail placement was significantly higher than that of the control group(P<0.01).After treatment,the ratio of anterior and posterior height of injured vertebrae was higher and the angle of Cobb was lower than that before treatment,the JOA score of lumbar vertebrae was higher than that before treatment,and the JOA score of lumbar vertebrae at 6 months after operation was higher than that before treatment in both groups(P<0.01).There was no significant difference in the ratio of anterior and posterior vertebral height,Cobb angle and lumbar JOA score between the two groups before and after treatment(P>0.05).Conclusion 3 D printing technique improved the accuracy of pedicle screw placement for thoracolumbar fracture and reduced the number of fluoroscopy and bleeding amount,which is worthy of clinical application.
引文
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