3D打印技术辅助TESSYS减压术治疗腰椎管狭窄的疗效分析  

Analysis of the effect of 3D printing technology assisted TESSYS decompression in the treatment of lumbar spinalstenosis

作　　者：李锐 张仁赞 刘正蓬[1] 孙贺[1] 张义龙[1] LI Rui;ZHANG Ren-zan;LIU Zheng-peng;SUN He;ZHANG Yi-long(Deparment of Spinal Surgery,Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)

机构地区：[1]承德医学院附属医院脊柱外科,河北承德067000

出　　处：《局解手术学杂志》2021年第5期395-399,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：承德市科学技术研究与发展计划(201904A031)。

摘　　要：目的探究3D打印技术辅助经皮椎间孔镜(TESSYS)减压术对腰椎管狭窄患者术后创伤应激、腰椎功能及并发症的影响。方法选取114例腰椎管狭窄患者作为研究对象开展前瞻性研究,按照随机数字表法分为对照组和观察组,每组57例。对照组采取TESSYS减压术治疗,观察组采取3D打印技术辅助TESSYS减压术治疗。比较2组手术情况、术后恢复情况、手术前后创伤应激指标C反应蛋白(CRP)、单核细胞趋化蛋白(MCP-1)、肌酸激酶(CK)、前列腺素E2(PGE2)、腰腿痛视觉模拟量表(VAS)评分、腰椎功能Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗(JOA)评分、腰椎功能优良率及并发症发生情况。结果观察组术中失血量少于对照组(P<0.05),手术时间、术后下地时间、住院时间短于对照组(P<0.05);观察组术后1 d、3 d、7 d血清CRP、MCP-1、CK、PGE2水平均低于对照组(P<0.05);观察组术后1个月、6个月、12个月腰部、腿部VAS评分均低于对照组(P<0.05);观察组术后1个月、6个月、12个月ODI均低于对照组(P<0.05),JOA评分均高于对照组(P<0.05);观察组腰椎功能优良率高于对照组(P<0.05);观察组并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论采取3D打印技术辅助TESSYS减压术治疗腰椎管狭窄,能有效缩短手术时间,减少手术创伤,从而减轻术后创伤应激反应,促进患者术后恢复,且能进一步减轻患者腰腿疼痛,改善腰椎功能。Objective To explore the effect of 3D printing technology assisted transforaminal endoscopic spine system(TESSYS)decompression on postoperative traumatic stress,lumbar function and complications in patients with lumbar spinal stenosis.Methods A total of 114 patients with lumbar spinal stenosis were selected as the research objects for prospective research.According to the random number table method,they were divided into the control group and the observation group,with 57 cases in each group.The control group was treated with TESSYS decompression,and the observation group was treated with 3D printing technology assisted TESSYS decompression.The operation status,postoperative recovery status,trauma stress indicators[C reactive protein(CRP),monocyte chemoattractant protein(MCP-1),creatine kinase(CK),prostaglandin E2(PGE2)],visual analogue scale(VAS)score for low back and leg,lumbar spine function[Oswestry dysfunction index(ODI),Japanese Orthopedic Association(JOA)score]before and after operation,the excellent and good rate of lumbar spine function and the occurrence of complications were compared between the two groups.Results The amount of blood loss during operation in the observation group was less than that in the control group,and the operation time,postoperative time to the ground,and hospital stay in the observation group were shorter than those in the control group(P<0.05).Serum CRP,MCP-1,CK,and PGE2 levels in the observation group were lower than those in the control group at 1 day,3 days,and 7 days after operation(P<0.05).The VAS scores of low back and leg in the observation group were lower than those in the control group at 1 month,6 months and 12 months after operation(P<0.05).At 1 month,6 months,and 12 months after operation,the ODI of the observation group was lower than that of the control group(P<0.05),and the JOA score was higher than that of the control group(P<0.05).The excellent and good rate of lumbar function in the observation group was higher than that of the control group(P<0.05).There was

关 键 词：腰椎管狭窄 3D打印技术 经皮椎间孔镜减压术 创伤应激 腰椎功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]