个体化3D打印技术辅助空心加压螺钉治疗AndersonⅡ型齿状突骨折的临床应用  

Clinical application of individual 3D printing auxiliary compressed hollow screws surgery treating of AndersonⅡ type odontoid fracture

作　　者：梁亮科[1] 禤天航 

机构地区：[1]广东省佛山市中医院骨科,广东佛山528000

出　　处：《中国医药导报》2017年第9期98-102,共5页China Medical Herald

基　　金：广东省佛山市医学类科技攻关项目(2015AB00332)

摘　　要：目的观察个体化3D打印技术辅助空心加压螺钉治疗AndersonⅡ型齿状突骨折的临床效果。方法选择2015年1月~2016年12月佛山市中医院AndersonⅡ型齿状突基底骨折的40例患,者按随机数字表法分为治疗组和实验组,每组各20例。治疗组患者采用个体化3D打印技术辅助空心加压螺钉置钉术,对照组患者采用常规齿状空心加压螺钉置钉术。比较两组患者手术操作情况(手术时间、术中出血量、透视时间、置钉准确率)以及术后融合效果(包括枢椎愈合情况、螺钉松动或断裂发生率)。结果手术情况:治疗组在手术时间、术中出血量、透视时间和置钉准确率均优于对照组,差异有统计学意义(P<0.05)。术后融合效果:治疗组所有病例均得到骨性融合,无断裂或松动,对照组有4例患者出现骨折不融合,3例伴有螺钉松动,1例出现螺钉断裂,治疗组的骨性融合率、螺钉松动或断裂发生率优于对照组,差异有统计学意义(P<0.05)。结论个体化3D打印技术导板钉道置钉手术操作简单,置钉精确性高,能减少医生操作时间,提高术后骨折融合率,对临床上治疗AndersonⅡ型齿状突骨折有指导作用。Objective To observe the clinical effect of individual 3D printing auxiliary compressed hollow screws surgery treating Anderson Ⅱ type odontoid fracture. Methods From January 2015 to December 2016, in Foshan Hospi- tal of TCM, 40 patients with Anderson Ⅱ type odontoid fracture criteria were selected, they were divided into two groups by random number table, with 20 cases in each group. Treatment group was given individual 3D printing auxil- iary compressed hollow screws surgery, control group was given convention compressed hollow screws way. The opera- tion situation （surgery time, intranperative bleeding, X-ray times and accuracy rate） and postoperative fusion effect （in- cluded odontoid fusion rates, loose or screws extraction rates） of two groups were campared. Results On operation situa- tion： intranperative bleeding, X-ray times and accuracy rate in treatment group were better than those in control group, the differences were statistically significant （P 〈 0.05）. On postoperative fusion effect： all patients in treatment group received odontoid fusion, without loose or screws extraction; there were 4 unfusion cases, 3 loosing cases and 1 screws extraction case in control group, odontoid fusion rates, loose or screws extraction rates in treatmnet group were better than those in control group, the differences were statistically significant （P 〈 0.05）. Conclusion The method of individ- ual 3D printing auxiliary compressed hollow screws has a guiding role on treating Anderson Ⅱ type odontoid fracture, which is easy for operate, accurate inserting, shortening times and improving fusion rates.

关 键 词：3D打印技术 加压空心螺钉 型齿状突骨折 

分 类 号：R687.3[医药卫生—骨科学]