3D打印椎间融合器置入治疗脊髓型颈椎病:颈椎曲度及椎间高度恢复的半年随访  

Application of 3D printed interbody fusion cage for cervical spondylosis of spinal cord type:half-year follow-up of recovery of cervical curvature and intervertebral height

作　　者：刘正蓬[1] 王雅辉[1] 张义龙[1] 明颖 孙志杰[1] 孙贺[1] Liu Zhengpeng;Wang Yahui;Zhang Yilong;Ming Ying;Sun Zhijie;Sun He(Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei Province,China)

机构地区：[1]承德医学院附属医院,河北省承德市067000

出　　处：《中国组织工程研究》2021年第6期849-853,共5页Chinese Journal of Tissue Engineering Research

基　　金：2015年承德市科学技术研究与发展计划项目(20157060),项目负责人:刘正蓬。

摘　　要：背景:近期临床研究发现,生物材料植入过程中机体内环境会产生一定改变,出现不同程度的免疫、应激反应,且不同生物材料机体免疫、应激反应亦有明显差异。目的:探讨3D打印椎间融合器在脊髓型颈椎病中的应用效果及对患者血清皮质醇、去甲肾上腺素水平的影响。方法:选择2015年7月至2018年7月承德医学院附属医院收治的脊髓型颈椎病患者63例,其中男40例,女23例,年龄30-78岁,按照随机数字表分为研究组(n=31)、对照组(n=32),均接受颈椎前路减压植骨融合内固定治疗,研究组术中植入3D打印椎间融合器,对照组植入聚醚醚酮材料椎间融合器及同种异体骨。对比两组手术情况、并发症发生情况,术前及术后1,3 d检测血清皮质醇、去甲肾上腺素水平,术前及术后1周、6个月检测颈椎曲度、椎间高度,术后6个月统计轴性症状。试验获得承德医学院附属医院伦理委员会批准。结果与结论:①两组手术时间、术中出血量、住院时间比较差异无显著性意义(P>0.05);②研究组31例发生螺钉松动1例、植入物移动1例,对照组32例中发生螺钉松动3例、免疫排斥3例、植入物移动2例、植入物塌陷1例,研究组并发症发生率低于对照组(P<0.05);③两组术后1,3 d的皮质醇、去甲肾上腺素水平均高于术前(P<0.05),但研究组低于对照组(P<0.001);④两组术后1周、6个月的颈椎曲度、椎间高度均高于术前(P<0.05),且研究组高于对照组(P<0.05);⑤研究组术后6个月轴性症状轻于对照组(P<0.05);⑥结果表明,3D打印椎间融合器应用于脊髓型颈椎病可减少并发症,促进颈椎曲度、椎间高度恢复,提高颈椎稳定性,且机体应激反应、轴性症状轻。BACKGROUND:Recent clinical studies have found that during the implantation of biomaterials,the internal environment of the body will change to a certain extent,and different levels of immunity and stress responses will occur.There are also obvious differences in the immune and stress responses of different biological materials.OBJECTIVE:To investigate the effect of 3D printed interbody fusion cage on patients with cervical spondylosis of spinal cord type and its effect on serum cortisol and norepinephrine levels.METHODS:Sixty-three patients with cervical spondylotic myelopathy who were admitted to the Affiliated Hospital of Chengde Medical University from July 2015 to July 2018 were selected,including 40 males and 23 females,aged 30-78 years old.The patients were randomly divided into a research group(n=31)and a control group(n=32)according to a random number table.All patients received anterior cervical decompression and bone graft fusion and internal fixation.Patients in the research group were implanted with 3D printed intervertebral fusion cage during operation.The patients in the control group were implanted with polyetheretherketone interbody fusion cage and allogeneic bone.The operation and complications of the two groups were compared.Serum cortisol and norepinephrine levels were detected before and 1 and 3 days after operation.Cervical curvature and intervertebral height were measured before surgery,1 week,and 6 months after surgery.Axial symptoms were counted at 6 months after surgery.The trial was approved by the Ethics Committee of the Affiliated Hospital of Chengde Medical University.RESULTS AND CONCLUSION:(1)Operation time,intraoperative blood loss and hospitalization time were not significantly different between the two groups(P>0.05).(2)Among 31 cases,there were 1 case of screw loosening and 1 case of implant movement in the research group.Among 32 cases,there were 3 cases of screw loosening,3 cases of immune rejection,2 cases of implant movement,and 1 case of implant collapse in the control group

关 键 词：骨 植入物 颈椎病 3D打印 椎间融合器 颈椎曲度 椎间高度 皮质醇 去甲肾上腺素 

分 类 号：R459.9[医药卫生—治疗学] R392.4[医药卫生—临床医学]