3D打印技术辅助下L5S1椎间盘突出症椎间孔镜治疗的临床研究  

3D printed skeletal model in the treatment of L5S1 lumbar intervertebral disc herniation by percutaneous spinal endoscopic lumbar discectomy

作　　者：刘伯龄 张煌 陈齐勇 王华锋 刘少强 陈伟 梁珪清 LIU Boling;ZHANG Huang;CHEN Qiyong;WANG Huafeng;LIU Shaoqiang;CHEN Wei;LIANG Guiqing(Department of Spine Surgery,Fuzhou Second Hospital Affiliated to Xiamen University,Fuzhou,Fujian 350007,China)

机构地区：[1]厦门大学附属福州第二医院脊柱外科,福州350007

出　　处：《福建医药杂志》2020年第3期9-13,共5页Fujian Medical Journal

基　　金：2017年福州市卫生计生系统科技计划项目(2017-S-wt3)。

摘　　要：目的探讨3D打印骨骼模型在经皮椎间孔镜髓核摘除术治疗L5S1腰椎间盘突出症中的可行性及临床效果。方法回顾性分析我院椎间盘突出症患者50例,将患者随机分为观察组和对照组,各25例。观察组采用3D打印骨骼模型辅助经皮椎间孔镜髓核摘除术,术前分析髓核突出部位及硬膜和神经根受压情况,规划穿刺路线,并模拟操作;对照组常规经皮椎间孔镜髓核摘除术,记录两组在术前、术后第1天腿痛疼痛视觉模拟评分(VAS),并对比两组患者术中透视次数、手术时间及术后3个月随访时腰椎Oswestry功能障碍指数。结果两组术后腿痛VAS评分较术前降低,差异有统计学意义(P<0.05);观察组与对照组的透视次数分别为(7.5±1.6)次、(13.9±1.4)次,两组比较差异有统计学意义(P<0.05);观察组与对照组的手术时间分别为(72.2±8.5)min、(95.2±10.5)min,差异有统计学意义(P<0.05)。结论采用3D打印骨骼模型术前可规划穿刺路线,模拟穿刺可减少术中透视次数与手术时间,对经皮椎间孔镜技术在L5S1椎间盘突出症中的应用具有指导意义。Objective To explore the feasibility and clinical effect of 3 D printed skeletal model in the treatment of L5S1 lumbar intervertebral disc herniation by percutaneous spinal endoscopic lumbar discectomy.Methods A retrospective analysis of 50 patients admitted from August 2017 to December 2019, including 28 males and 22 females;aged 21 to 62, with an average of(42.5±0.5)years old, using a random number table method, randomly divided into test group and controls group, the test group used 3 D printed skeletal model to assist percutaneous spinal endoscopic lumbar discectomy, preoperatively plan the puncture route and simulate the operation;the control group use traditional percutaneous spinal endoscopic lumbar discectomy, two groups underwent visual analogue scale(VAS) before and after the operation, and times of fluoroscopy, operation time, and lumbar oswestry dysfunction index at 3-month follow-up.Results The VAS score of postoperative leg pain in the two groups was lower than that before operation, The difference was statistically significant;The times of fluoroscopy in the experimental group and the control group were(7.5±1.6) and(13.9±1.4), the difference between the two groups was statistically significant(P<0.05);the operation time was(72.2±8.5) and(95.2±10.5), and the difference was statistically significant.(P<0.05).Conclusion Using 3 D printing model, you can plan the puncture route, simulate the operation, reduce fluoroscopy and the operation time, and have the guidance of the application of percutaneous spinal endoscopic lumbar discectomy in L5S1 significance.

关 键 词：3D打印 腰椎间盘突出症 椎间孔镜 L5S1 

分 类 号：R683[医药卫生—骨科学]