3D打印人工椎体治疗脊髓型颈椎病的疗效及快速康复护理研究  

Study on the curative effect and fast rehabilitation nursing of artificial vertebral body by 3D printing on treating cervical spondylotic myelopathy

作　　者：刘志伟[1] 李铁军[2] 姜伟[1] 刘钢 刘奔 刘彬彬 崔涛 王力国[1] 代会生 杨健 LIU Zhi-wei;LI Tie-jun;JIANG Wei(Department of Orthopaedics,Cangzhou Central Hospital,Cangzhou 061001,China;不详)

机构地区：[1]沧州市中心医院骨科,河北沧州061001 [2]沧州市中心医院手术室,河北沧州061001

出　　处：《中国医学装备》2020年第9期111-114,共4页China Medical Equipment

基　　金：沧州市重点研发计划(172302169)“磁共振IDEAL—IQ技术在颈椎前路融合术后邻近节段退变中的应用”。

摘　　要：目的:探讨三维(3D)打印人工椎体治疗脊髓型颈椎病的临床疗效及围术期快速康复护理研究。方法:选取在医院住院治疗的10例脊髓型颈椎病患者,均行颈椎前路减压3D打印人工椎体植入术,围术期采用快速康复外科理念,观察患者术后椎体融合及内固定并发症。统计术前、术后及末次随访时的视觉模拟评分(VAS)评分和日本骨科学会(JOA)评分,以及JOA改善率。结果:随访8~18个月,平均12.3个月,患者均未出现椎体内固定松动、移位、断裂等内固定并发症,X射线片均显示植骨融合。术后24 h、1周VAS评分较术前明显降低,差异有统计学意义(t=2.216,t=1.469;P<0.05);术后JOA评分较术前均明显改善,差异有统计学意义(t=8.120,P<0.05),且改善率为76.20%;满意度评分较术前明显升高,差异有统计学意义(t=5.069;P<0.05)。结论:3D打印人工椎体植入术治疗脊髓型颈椎病短期内均能显著改善脊髓功能和临床症状,围术期针对性实施快速康复外科理念,可减少手术并发症、提高患者满意度。Objective:To explore the clinical efficacy of artificial vertebral body that was produced by 3 dimensional(3D)printing in treating cervical spondylotic myelopathy and the perioperative rapid rehabilitation nursing.Methods:Ten patients with cervical spondylotic myelopathy who were hospitalized in our hospital were selected.All patients underwent anterior cervical decompression 3D printing artificial vertebral implantation.The concept of fast track surgery was adopted during the perioperative period.And the postoperative complications of vertebral fusion and internal fixation of patients were observed.And the preoperative,postoperative and the last follow-up visual analogue scale(VAS)score,Japanese orthopaedic association(JOA)score and the JOA improvement rate were further calculated by statistic method.Results:The follow-up time was 8-18 months,and the average time was 12.3 months.There were no complications of internal fixation such as loosening,displacement,fracture of internal fixation of vertebral body in patients.And X-ray films of them showed bone graft fusion.The VAS score at the 24th hour and the 1st week after surgery was significantly lower than those before surgery(t=2.216,t=1.469,P<0.05).And the JOA score after surgery was significantly higher than that before surgery(t=8.120,P<0.05),and the JOA improvement rate was 76.20%.The score of satisfaction after surgery was significantly higher than that before surgery(t=5.069,P<0.05).Conclusion:3D printing artificial vertebral body implantation of treating cervical spondylotic myelopathy can significantly improve spinal cord function and clinical symptoms in the short term,and the implementation of the conception of fast track surgery with pertinence during perioperative period can reduce surgical complications and increase satisfaction of patient.

关 键 词：三维(3D)打印 脊髓型颈椎病 围术期管理 加速康复外科 

分 类 号：R681.5[医药卫生—骨科学] R473.6[医药卫生—外科学]