3D打印椎间融合器行颈椎前路融合手术治疗颈椎间盘突出症的早期临床研究  

Early Clinical Study on Anterior Cervical Fusion Surgery with 3D Printed Interbody Fusion Cage for Treatment of Cervical Disc Herniation

作　　者：白长双 张义德 郭建平[1] 刘权祥 李增新[1] 宋扬[1] BAI Changshuang;ZHANG Yide;GUO Jianping;LIU Quanxiang;LI Zengxin;SONG Yang(Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2023年第2期236-239,共4页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(JJKH20200071KJ)。

摘　　要：目的 评估3D打印椎间融合器行颈椎前路融合手术治疗颈椎间盘突出症的早期临床效果.方法 选取56例行颈椎前路融合手术治疗颈椎间盘突出症患者,其中30例选择3D打印椎间融合器(3D打印组)进行治疗,26例选择聚醚醚酮(PEEK)椎间融合器(PEEK组).记录并比较两组患者手术时间、术中失血量、住院时间及并发症发生情况;术前、术后3 d、术后6个月采用日本骨科协会(JOA)评分评价神经功能改善情况,采用VAS评分评价上肢和颈部疼痛改善情况,测量融合节段Cobb角,并计算术后3 d与术前、术后6个月与术后3 d的差值.结果 所有患者均获得随访,3D打印组手术时间少于PEEK组(P<0.05),术中失血量、住院时间两组间比较差异无统计学意义(P>0.05),PEEK组术后1例患者发生进食呛咳,术后3个月恢复正常;JOA和VAS评分两组间比较差异无统计学意义(P>0.05);两组患者术后3 d较术前Cobb角均得到明显改善(P<0.05),术后6个月与术后3 d两组间Cobb角比较差异无统计学意义(P>0.05).结论 应用3D打印椎间融合器治疗颈椎间盘突出症疗效与PEEK融合器相当,但可以缩短手术时间,值得临床推广使用.Objective To evaluate the early clinical outcomes of anterior cervical fusion surgery with 3D printed interbody fusion cage for cervical disc herniation.Method The clinical data of 56 patients with cervical disc herniation receiving anterior cervical fusion surgery were selected,30 patients received the surgery with 3D printed interbody fusion cage who were included in 3D printing group and 26 patients received the surgery with polyetheretherketone(PEEK)interbody fusion cage who were included in PEEK group.The operation duration,intraoperative blood loss,length of hospitalization and complication rate of the patients were recorded;Japanese Orthopaedic Association(JOA)score was applied to evaluate the improvement of neurological function and neck and upper limb pain relief was assessed by VAS score before surgery,at 3 days after surgery and at 6 months after surgery,fusion segment Cobb angle was measured to calculate the differences between the angles at 3 days after surgery and before the surgery,at 6 months after surgery and at 3 days after surgery.Results All patients were followed up,the operation duration of 3D print group was shorter than that of PEEK group,the difference in the intraoperative blood loss and length of hospitalization between two groups showed no statistical significance(P>0.05);One patient had the irritant cough during eating in the PEEK group and the symptom disappeared at 3 months after surgery;The difference in JOA and VAS scores between two groups showed no statistical significance(P>0.05);The Cobb angles in two group all improved significantly at 3 days after surgery(P<0.05),there was no statistically significant difference between two groups at 6 months after surgery and at 3 days after surgery(P>0.05).Conclusion The efficacy of 3D printed interbody fusion cage on the cervical disc herniation was comparable to that of PEEK fusion cage,but 3D printed interbody fusion cage can decrease operation duration and is worth popularizing in the clinical practice.

关 键 词：3D打印 椎间融合 颈椎前路融合手术 颈椎间盘突出症 

分 类 号：R681[医药卫生—骨科学]