3D打印精确穿刺椎体成形在新发椎体压缩性骨折中的应用  

Application of three-dimensional printing in accurate puncture vertebroplasty in fresh vertebral compression fractures

作　　者：袁伶俐[1] 徐文弟[1] 白建中 张仲传 朱勋兵[1] 耿春辉[1] Yuan Lingli;Xu Wendi;Bai Jianzhong;Zhang Zhongchuan;Zhu Xunbing;Geng Chunhui(Department of Orthopedics,Second Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui Province,China)

机构地区：[1]蚌埠医学院第二附属医院骨科,安徽省蚌埠市233000

出　　处：《中国组织工程研究》2021年第30期4757-4761,共5页Chinese Journal of Tissue Engineering Research

基　　金：2019年蚌埠医学院自然科学重点课题(BYKY2019134ZD),项目负责人:袁伶俐。

摘　　要：背景:目前临床医生在采用经皮椎体成形修复椎体压缩性骨折时,如何精准操作并使骨水泥均匀分布于伤椎骨折块间,从而减轻腰背部疼痛症状,对于椎体压缩性骨折患者的术后康复至关重要。近年来发展的3D打印伤椎椎体技术可为临床外科医生提供伤椎解剖学参考依据。目的:探讨3D打印伤椎骨折模型和精确穿刺椎体成形在新发椎体压缩性骨折中的应用效果。方法:采用蚌埠医学院第二附属医院2019年2月至2020年8月新发椎体压缩性骨折患者60例,随机分成3D打印组和对照组,分别进行3D打印伤椎模型和精确穿刺骨折部位的经皮椎体成形和传统的经皮椎体成形修复。比较两组术中手术时间、透视次数、穿刺针更换穿刺点次数(简称穿刺次数)、骨水泥量,术后第1天、1周、4周、3个月目测类比评分的差异。结果与结论:(1)与对照组相比,3D打印组术后1 d、1周的目测类比评分均降低(P<0.05);(2)与对照组相比,3D打印组穿刺次数、X射线暴露次数和手术时间均减少(P<0.05),术中骨水泥注入量增加(P<0.05);(3)两组各有2例椎体局部骨水泥渗漏,术后无临床症状,随访期间两组均未见相邻椎体骨折病例出现;(4)结果证实,3D打印伤椎模型与椎体成形相结合,能够精确微创穿刺至骨折部位,在增加骨水泥注入量的同时还可有效避免骨水泥的渗漏,并在术后短时间内缓解患者术后腰背部疼痛。BACKGROUND:At present,when clinicians use percutaneous vertebroplasty to repair vertebral compression fractures,how do they accurately operate and evenly distribute the bone cement between the injured vertebral fractures,thereby reducing the symptoms of lower back pain,for patients with vertebral compression fractures,is essential for postoperative recovery.The technology of three-dimensional(3D)printed injured vertebral body developed in recent years can provide clinical surgeons with reference for the anatomy of injured vertebra.OBJECTIVE:To explore the clinical effect of 3D printed model of injured vertebral fracture and vertebroplasty by accurately puncturing in fresh vertebral compression fracture.METHODS:Sixty patients with vertebroplasty in the Second Affiliated Hospital of Bengbu Medical College from February 2019 to August 2020 were randomly divided into 3D printing group and control group.The accurately punctured vertebroplasty instructed by 3D printing model of the injured vertebra and the traditional vertebroplasty was performed respectively.The operation time,the times of fluoroscopy,the times of changing the puncture point,the amount of bone cement,and Visual Analogue Scale scores at 1 day,1,4 weeks and 3 months after operation were compared between the two groups.RESULTS AND CONCLUSION:(1)Visual Analogue Scale scores were lower in the 3D printing group than in the control group at 1 day and 1 week(P<0.05).(2)The operation time,the times of fluoroscopy,and the times of changing the puncture point were reduced(P<0.05);the amount of bone cement was increased(P<0.05)in the 3D printing group compared with the control group.(3)There were two cases of local vertebral cement leakage in both groups,and there were no clinical symptoms after operation.There was no case of adjacent vertebral fractures in both groups during the follow-up.(4)The results show that the combination of 3D printing model of the injured vertebra and vertebroplasty can guide the accurate puncture of pedicle,make it easier for the punct

关 键 词：骨 骨折 椎体 压缩性骨折 3D打印 椎体成形 骨水泥 模型 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]