基于3D打印的腰椎椎弓根螺钉治疗腰椎退变性疾病的临床应用  

Lumbar pedicle screw-based 3D printing of lumbar degenerative disease clinical application

作　　者：杨长征[1,2] 裴晓东[3] 柴红生 韩刚[3] 

机构地区：[1]包头医学院研究生学院,内蒙古包头014000 [2]山西省太原市化学工业集团有限公司职工医院骨科,山西太原030021 [3]包头市第四医院骨二科,内蒙古包头014000

出　　处：《临床医学研究与实践》2016年第24期1-3,共3页Clinical Research and Practice

基　　金：包头市医药卫生科技计划项目(No.Wsjj2015034)

摘　　要：目的探讨腰椎退变性疾病患者采用3D打印技术制作的导航模板来辅助腰椎椎弓根螺钉置入的可行性和有效性。方法选取我院脊柱外科收治的腰椎退变性疾病患者64例作为研究对象,随机分成观察组和对照组两组,每组32例,观察组采用术前采集的CT详细数据资料联合3D打印技术制作的导航模板来辅助腰椎椎弓根螺钉置入进行治疗;对照组患者则采用微创腰椎椎间固定融合术(mis-tlif)进行治疗,术后采用CT和X射线对置钉效果进行评价,所有患者随访12个月,然后采用JOA下腰痛评分系统和Oswestry功能障碍指数问卷表分别评价临床治疗效果和腰椎功能改善情况。结果观察组在置钉准确率、JOA下腰痛评分系统评分,治疗后优良率及Oswestry功能障碍指数问卷表评分方面均优于对照组,两者比较差异有统计学意义(P<0.05)。结论腰椎退变性疾病患者采用3D打印技术制作的导航模板来辅助腰椎椎弓根螺钉置入的准确率高,临床疗效好,能够显著改善患者的腰椎功能,值得临床上进行推广应用。Objective To investigate the feasibility and effectiveness of patients with lumbar degenerative disease using 3D printing technology to produce navigation template to assist of lumbar pedicle screw placement. Methods Sixty-four patients with spine surgery lumbar degenerative disease in our hospital were randomly divided into observation group and control group, with 32 cases in each group. The observation group used preoperative CT detailed data collected before treatment joint with 3D printing technology to assist navigation template lumbar pedicle screw placement, the control group used minimally invasive lumbar intervertebral fusion （mis-tlif） treatment, after treatment CT and X-ray were used to evaluate the effect of pedicle screws, all patients were followed-up for 12 months, then the development of JOA lumbar function and clinical effects were evaluated with low back pain scoring system and Oswestry disability index questionnaire. Results The nailing accuracy of pedicle screws, scores of JOA low back pain scoring system, the excellent rate after treatment and index of the Oswestry scoring system in observation group were superior to those of control group, the differences were statistically significant （P〈0.05）. Conclusion For patients with degenerative lumbar degenerative diseases, navigation template assisted lumbar pedicle screw placement produced by 3D printing technology shows high accuracy and clinical efficacy, which can significantly improve function in patients with lumbar and is worthy of clinical application.

关 键 词：3D打印技术 腰椎椎弓根螺钉 腰椎退变性疾病 

分 类 号：R687.3[医药卫生—骨科学]