3D打印导向器椎弓根螺钉固定寰枢椎骨折脱位  

3D-printed guider used for pedicle screw fixation of atlantoaxial fracture and dislocation

作　　者：周建国[1] 段永壮[2] ZHOU Jian-guo;DUAN Yong-zhuang(Department of Orthopedics,The First Peopled Hospital of Shangqiu City,Shangqiu 476000,China;Department of Orthopedics,The First Affiliated Hospital,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]商丘市第一人民医院骨科,河南商丘476000 [2]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《中国矫形外科杂志》2021年第12期1087-1090,共4页Orthopedic Journal of China

摘　　要：[目的]评价标杆型3D打印导向器在寰枢椎骨折脱位椎弓根螺钉内固定手术的应用价值。[方法]回顾性分析2016年12月—2018年11月本院椎弓钉固定寰枢椎骨折脱位80例患者的临床资料,其中42例采用标杆型3D打印导向器辅助置钉,38例采用常规C形臂透视辅助置钉。比较两组患者围手术期、随访与影像资料。[结果]导向器组手术时间、术中出血量、透视次数均显著优于常规组(P<0.05)。随时间推移,两组患者VAS评分显著减少,而JOA评分显著增加(P<0.05);相应时时间点两组间VAS和JOA评分的差异均无统计学意义(P>0.05)。影像方面,导向器组螺钉置入准确度分级显著优于常规组(P<0.05)。至末次随访,所有患者均达到骨性愈合,无内固定物松动、断裂。[结论]标杆型3D打印导向器可显著提高寰枢椎骨折、脱位椎弓根螺钉内固定术置钉的准确性,提升手术效率。[Objective] To evaluate the value of 3 D printed guider used for pedicle screw fixation of atlantoaxial fracture and dislocation. [Methods] A retrospective study was done on 80 patients who underwent pedicle screw fixation of atlantoaxial fractures and dislocations in our hospital from December 2016 to November 2018. Of them, 42 patients received pedicle screw fixation under the individual 3 Dprinted guider, while the remaining 38 patients had the fixation performed by the conventional free-hand technique. The perioperative, follow-up and radiographic documents were compared between the two groups. [Results] The guider group proved significantly superior to the conventional group regarding operation time, intraoperative bleeding, and times of fluoroscopy(P<0.05). As time went, the VAS score significantly decreased, whereas the JOA score significantly increased in both groups(P<0.05). However, no statistically significant differences were found between the two groups in the VAS and JOA scores at any matching time point(P>0.05). In term of radiographic evaluation,the guider group was significantly superior to the conventional groups in accuracy of pedicle screw placement(P<0.05). To the latest follow up, all patients in both groups achieved bony atlantoaxial fusion without loosening or breaking of the implants. [Conclusion] The 3 D-printed guider does considerably improve the accuracy of pedicle screw placement and efficacy of surgical operation for atlantoaxial fracture and dislocation.

关 键 词：寰枢椎骨折脱位 标杆型3D打印导向器 椎弓根螺钉内固定 

分 类 号：R683.2[医药卫生—骨科学]