摘要
目的:探讨胸腰椎骨折经皮微创椎弓根螺钉内固定术(PSF)手术联合计算机辅助设计3D打印技术对置入螺钉效果及预后的影响。方法:选取医院收治的112例胸腰椎骨折患者,均接受经皮微创PSF手术,依据术前设计方案的不同将其分为观察组(60例)和对照组(52例)。观察组术前采用计算机辅助设计3D打印技术方案,对照组术前采用常规CT评估方案。比较两组患者的手术情况、置入螺钉准确率、并发症、术后1年伤椎复位及预后情况。结果:观察组手术时间短于对照组,术中出血量和术中X射线透视次数均少于对照组,两组比较差异有统计学意义(t=4.914,t=3.157,t=14.847;P<0.05)。观察组一次置入螺钉准确率和总体置入螺钉准确率分别为89.17%和98.33%,高于对照组的78.85%和90.38%,其差异有统计学意义(x2=4.501,x2=6.943;P<0.05)。术后1年,观察组椎体滑脱率及Cobb角均小于对照组,椎体前缘高度大于对照组,其差异有统计学意义(t=19.047,t=2.891,t=2.494;P<0.05)。观察组预后良好率为96.67%,高于对照组的86.54%,差异有统计学意义(x2=3.867,P<0.05)。结论:借助计算机辅助设计3D打印技术,选择最佳手术入路和复位方案行经皮微创PSF手术治疗胸腰椎骨折,有利于提高手术效率,且预后效果更好。
Objective:To explore the effects of percutaneous minimally invasive pedicle screw fixation(PSF)surgery combined with three dimensional(3D)printing technique with computer-aided design in thoracolumbar vertebral fra cture on the implanted screw and prognosis.Methods:A total of 112 patients with thoracolumbar vertebral fractures who admitted to the hospital were selected as the study subjects.All of them underwent percutaneous minimally invasive PSF surgery.And they were divided into observation group(60 cases)and control group(52 cases)according to the different preoperative designing scheme.The observation group adopted 3D printing technique scheme with computer-aided design before surgery,and the control group adopted conventional computed tomography(CT)assessment scheme before surgery.The surgical status,the accuracy of implanted screw,complications,restoration of the injured vertebral at 1 year post operation and prognosis between the two groups were compared.Results:The operation time of observation group was significantly shorter than that of control group,and the amount of intraoperative bleeding and the frequency of X-ray fluoroscopy of observation group were significantly less than these of control group(t=4.914,t=3.157,t=14.847,P<0.05).The accuracy rate that screw was implanted at one-time and the accuracy rate of totally implanted screw in observation group were 89.17%and 98.33%,respectively,which were significantly higher than 78.85%and 90.38%in control group(x2=4.501,x2=6.943,P<0.05),respectively.At one year after operation,the rate of spondylolisthesis and Cobb angle of observation group were significantly lower than those of control group,and the height of the anterior edge of the vertebral body of observation group was significantly larger than that of control group(t=19.047,t=2.891,t=2.494,P<0.05).The favorable rate of prognosis of observation group was 96.67%,which was significantly higher than 86.54%of control group(x2=3.867,P<0.05).Conclusion:The 3D printing technique with the computer-aided design,which is used to select the optimal operative approach and restoration scheme to perform percutaneous minimally invasive PSF surgery for treating thoracolumbar vertebral fractures,is conducive to improve surgical efficiency.And its prognosis effect is better.
作者
章飞翔
崔海东
吕书军
蒋栋
吕畅
ZHANG Fei-xiang;CUI Hai-dong;LV Shu-jun(Department of Orthopedics,Hai'an People's Hospital,Hai’an 226600,China)
出处
《中国医学装备》
2020年第12期96-100,共5页
China Medical Equipment
关键词
胸腰椎骨折
计算机辅助设计
3D打印技术
椎弓根螺钉内固定术
预后
Thoracolumbar vertebral fractures
Computer-aided design
3D printing technology
Pedicle screw fixation
Prognosis
