3D打印辅助四级截骨术治疗创伤性脊柱后凸畸形30例  

Clinical Report of 30 Cases of 3D Printing Assisted SRS-Schwab Ⅳ Osteotomy in the Treatment of Traumatic Kyphosis

作　　者：陈毅 赵亮[1] 王利民[1] CHEN Yi;ZHAO Liang;WANG Limin(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450000

出　　处：《中国中医骨伤科杂志》2021年第2期41-44,48,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：河南省医学科技攻关计划项目(2018020041)。

摘　　要：目的:探讨3D打印辅助四级截骨术在治疗创伤性脊柱后凸畸形的术前规划及术中辅助操作中的应用价值。方法:回顾性分析2019年1月至2019年12月接受3D打印辅助四级截骨术治疗的30例创伤性脊柱后凸畸形患者的临床资料,测量患者术前、术后2周及末次随访时的影像学参数。使用疼痛视觉模拟(VAS)评分和Oswestry功能障碍指数(ODI)评估临床症状缓解情况。结果:本组患者均获得随访,随访时间为12~20个月,平均(15.7±3.1)个月,术口愈合良好,未出现感染、内固定松动、神经、血管损伤等并发症。Cobb角及腰椎前凸角(LL)术后2周与术前比较,差异均有统计学意义(P<0.05),Cobb角及LL术后2周与末次随访比较,差异均无统计学意义(P>0.05)。术前与术后2周、术后2周与末次随访的矢状面平衡(SVA)、骨盆投射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)比较,差异均无统计学意义(P>0.05)。术后2周及末次随访VAS评分和ODI较术前均明显改善(P<0.05)。结论:3D打印模型可直观地显示创伤性脊柱后凸畸形椎体的形状、严重程度及其与邻近椎体、血管、神经的空间关系,术前预模拟置钉、截骨、内固定等,可为实际手术提供参考。3D打印辅助四级截骨术治疗创伤性脊柱后凸畸形具有可行性,且临床效果满意。Objective:To explore the clinical effect of 3 D printing assisted SRS-SchwabⅣosteotomy in the treatment of traumatic kyphosis.Methods:A retrospective analysis of the clinical data of 30 patients with traumatic kyphosis who underwent 3 D printing-assisted SRS-SchwabⅣosteotomy from January 2019 to December 2019.The imaging parameters of the patients were measured before operation,2 weeks after operation and at the last follow-up.The visual analogue scales(VAS)score and Oswestry disability index(ODI)were used to assess the relief of clinical symptoms.Results:There were statistically significant differences between postoperative 2 weeks and preoperative in Cobb angle and LL(lumbar lordosis)angle(P<0.05).There was no statistically significant differences between postoperative 2 weeks and the last follow-up in Cobb angle and LL angle(P>0.05).There was no statistically significant difference in SVA(sagittal vertical axis),PI(pelvic incidenxe),PT(pelvic tilt)and SS(sacral slope)between preoperative and postoperative 2 weeks,and between postoperative 2 weeks and the last follow-up(P>0.05).VAS score and ODI index were significantly improved 2 weeks after operation and at the last follow-up(P<0.05).Conclusion:The 3 D printing model can visually show the shape and severity of the vertebral body of traumatic kyphosis and its spatial relationship with adjacent vertebral bodies,blood vessels and nerves.Pre-operative simulation of screw placement,osteotomy,internal fixation,etc,can provide reference for actual surgery.3 D printing assisted SRS-SchwabⅣosteotomy is feasible for treatment of traumatic kyphosis,with better correction of kyphosis,and high intervertebral fusion rate.

关 键 词：3D打印 脊柱后凸 畸形 截骨 

分 类 号：R682.3[医药卫生—骨科学]