摘要
目的探讨3D打印导航模板辅助后路寰枢椎手术置钉的应用效果。方法回顾性分析2017年9月至2020年2月西安交通大学第二附属医院收治的22例寰枢椎疾病患者资料。根据是否使用3D打印导航模板辅助后路术中置钉将患者分为对照组(n=11)和实验组(n=11)。对照组男6例,女5例;年龄(63.6±4.6)岁。实验组男7例,女4例;年龄(57.6±4.8)岁。对照组术中采用常规X线辅助置钉,实验组术前根据CT数据进行三维建模、设计并打印后路寰枢椎椎三维模型和导航模板,指导术中置钉。比较两组患者的手术时间、术中透视次数、出血量及置钉准确率。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。对照组共置入螺钉44枚,其中Ⅰ类螺钉12枚,Ⅱ类螺钉20枚,Ⅲ类螺钉12枚,置钉成功率为72.7%。实验组共置入螺钉44枚,其中Ⅰ类螺钉21枚,Ⅱ类螺钉19枚,Ⅲ类螺钉4枚,置钉成功率为90.9%;实验组置钉成功率显著高于对照组,差异有统计学意义(P<0.05)。实验组的手术时间[(120.0±5.0)min]、透视次数[(9.9±0.5)次]、出血量[(96.6±4.2)mL]均显著低于对照组[(153.1±5.3)min、(12.2±0.7)次、(128.5±5.1)mL],差异均有统计学意义(P<0.05)。结论3D打印导航模板可以有效减少手术时间、术中出血量和透视次数,提高置钉成功率,在寰枢椎后路手术中有极好的应用前景。
Objective To investigate the efficacy of 3D printed navigation template in posterior atlantoaxial surgery.Methods A retrospective study was conducted of the 22 patients who had received posterior atlantoaxial surgery for atlantoaxial diseases at The Second Department of Orthopedics,The Second Hospital Affiliated to Xi'an Jiao Tong University from September 2017 through February 2020.They were divided into a control group(n=11)and an experimental group(n=11)according to whether a 3D printed navigation template had been used to assist the posterior atlantoaxial surgery.In the control group,there were 6 males and 5 females,with an age of 63.6 years±4.6 years.In the experimental group,there were 7 males and 4 females,with an age of 57.6 years±4.8 years.In the control group,the pedicle screws were inserted with the help of conventional X-ray;in the experimental group,the pedicle screws were implanted with the assistance of a 3D printed navigation template and a 3D printed 3D model of cervical spine based on the preoperative CT data.Recorded were surgery time,times of intraoperative fluoroscopy,blood loss and success rate of pedicle screw insertion.Results There were no significant differences between the 2 groups in the preoperative general data,showing comparability(P>0.05).A total of 44 pedicle screws were inserted in the control group,including 12 ones of level-Ⅰ,20 ones of level-Ⅱand 12 ones of level-Ⅲ,giving a success rate of 72.7%;a total of 44 pedicle screws were inserted in the experimental group,including 21 ones of level-Ⅰ,19 ones of level-Ⅱand 4 ones of level-Ⅲ,giving a success rate of 90.9%.The success rate in the experimental group was significantly higher than in the control group(P<0.05).The surgery time(120.0 min±5.0 min),times of tntraoperative fluoroscopy(9.9 times±0.5 times),and blood loss(96.6 mL±4.2 mL)in the experimental group were significantly lower than those in the control group(153.1 min±5.3 min,12.2 times±0.7 times and 128.5 mL±5.1 mL)(P<0.05).Conclusion Application of a 3D printing template can effectively reduce surgery time,intraoperative blood loss and intraoperative fluoroscopy but increase the success rate of pedicle screw implantation,showing excellent application prospects in posterior atlantoaxial surgery.
作者
欧阳鹏荣
贺西京
王栋
赵波
李楠
宁宁
崔凤
孙宏
秦杰
Ouyang Pengrong;He Xijing;Wang Dong;Zhao Bo;Li Nan;Ning Ning;Cui Feng;Sun Hong;Qin Jie(The Second Department of Orthopedics,The Second Hospital Affiliated to Xi'an Jiao Tong University,Xi'an 710032,China;Department of Emergency,The Fourth Hospital of Shanxi Province,Xi'an 710032,China;Department of Orthopedics,The Honghui Hospital,Xi'an 710032,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2020年第10期862-866,共5页
Chinese Journal of Orthopaedic Trauma
基金
陕西省重点研发计划(2018SF-283)
陕西省创新人才推进计划(2020KJXX-028)。
关键词
颈椎
骨钉
脊柱损伤
3D打印
椎弓根螺钉置入
Cervical vertebrae
Bone nails
Spinal injuries
3D printing
Pedicle screw placement
