摘要
背景:脊柱严重畸形,解剖不规则,截骨矫形手术风险极高,重度僵硬性脊柱侧后凸患者需要术前制定个体化的、精准的置钉及截骨方案设计以降低手术风险。目的:探讨3D打印技术应用在重度僵硬性脊柱侧后凸畸形截骨矫形手术中的疗效。方法:将2015年1月至2017年6月32例重度僵硬性脊柱侧后凸畸形患者纳入研究,其中16例在3D打印技术辅助下行截骨矫形手术的患者作为试验组,即术前利用3D打印技术重建脊柱模型,在此基础上精确设计合理的截骨方案。其余16例在X射线常规影像学检查指导下行截骨矫形的患者为对照组。记录所有患者围术期相关指标、术后侧后凸畸形矫正效果、椎弓根螺钉置钉准确率及手术并发症发生率等相关指标。结果与结论:试验组患者的手术时间、术中出血量、术中透视次数、术后引流量、术后并发症发生率、术后侧凸及后凸Cobb角等7个指标均明显低于对照组,置钉准确率及侧凸和后凸矫形率明显高于对照组(P <0.05)。说明3D打印技术,为重度僵硬性脊柱侧后凸畸形患者截骨矫形术前制定了个体化的、更加精准的置钉及截骨矫形方案,可提高手术安全性,减小手术创伤,临床效果满意。
BACKGROUND:For severe rigid kyphoscoliosis patients,due to severe spinal deformity,and high risk for orthopedic surgery,designing an individualized and precise placement and osteotomy scheme preoperatively is needed to reduce surgery risk.OBJECTIVE:To evaluate the clinical effect of three-dimensional(3D)printing applied in the orthopedic surgery for severe rigid kyphoscoliosis.METHODS:Thirty-two patients with severe rigid kyphoscoliosis from January 2015 to June 2017 were included.Sixteen cases underwent 3D-assisted osteotomy(preoperative spinal reconstruction by 3D printing,and designing rational osteotomy scheme,trial group),and other 16 cases received orthopedic surgery under X-ray(control group).The perioperative indexes,postoperative correction effect,accuracy of pedicle screw placement and incidence of complications were recorded.RESULTS AND CONCLUSION:The operation time,intraoperative blood loss,intraoperative fluoroscopy time,postoperative drainage,postoperative incidence of complications,postoperative scoliosis and kyphosis Cobb angle in the trial group were significantly lower than those in the control group,but the accuracy of pedicle screw placement,scoliosis and kyphosis corrective rate were significantly higher than those in the control group(P<0.05).To conclude,based on 3D printing,an individualized and precise placement and osteotomy scheme is designed for severe rigid kyphoscoliosis,can improve the operation safety,reduce the trauma,and obtain satisfactory clinical outcomes.
作者
杨阳
刘林
薛文
王增平
钱耀文
高学民
范立真
文杰
Yang Yang;Liu Lin;Xue Wen;Wang Zeng-ping;Qian Yao-wen;Gao Xue-min;Fan Li-zhen;Wen Jie(Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,Gansu Province,China;Second Department of Orthopedics,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第31期4959-4964,共6页
Chinese Journal of Tissue Engineering Research
基金
甘肃省人民医院院内科研项目(17GSSY3-3)~~
作者简介
杨阳,男,1991年生,甘肃省平凉市人,甘肃中医药大学在读硕士,主要从事脊柱外科方面的研究;通讯作者:刘林,主任医师,硕士生导师,甘肃中医药大学临床医学院,甘肃省兰州市730000;甘肃省人民医院骨二科,甘肃省兰州市730000。
