3D打印辅助技术和传统置钉在先天性脊柱畸形矫正治疗中的效果比较  

Comparison of the efficacy on 3D printing assistive technology and traditional nail placement in congenital spinal deformities

作　　者：阿尖措[1] 李占银[1] 苗有泉[1] 赵洪顺 贾生龙 许志华[1] 郝岩 A Jiancuo;LI Zhanyin;MIAO Youquan;ZHAO Hongshun;JIA Shenglong;XU Zhihua;HAO Yan(Department of Spinal Surgery,Qinghai Red Cross Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海红十字医院脊柱外科,西宁810000

出　　处：《医学研究与战创伤救治》2023年第11期1166-1170,共5页Journal of Medical Research & Combat Trauma Care

基　　金：青海省科技计划项目(2021-ZJ-746)。

摘　　要：目的 分析3D打印辅助技术在先天性脊柱畸形患者中的疗效对比及对准确性的影响。方法 回顾性分析2017年3月-2022年12月期间青海红十字医院收治的78例先天性脊柱畸形患者临床资料。所有患者按照治疗方案分为3D辅助组与治疗组。所有患者均行脊柱畸形矫正治疗,对照组采用传统置钉技术,3D辅助组采用3D打印辅助技术,并对患者完成3个月门诊随访,比较两组置钉相关指标、视觉模拟疼痛(VAS)评分及主弯矫形率、影像学指标、置钉准确率与置钉并发症。结果 3D辅助组置钉时间、出血量、透视次数及术后7 d VAS评分低于传统置钉组(P<0.05);主弯矫形率高于传统置钉组(P<0.05);两组手术7 d后影像学指标得到改善;3D辅助组冠状面Cobb角、局部后凸角度、C7PL-CSVL及SVA水平低于传统置钉组(P<0.05);3D辅助组置钉准确率高于传统置钉组(P<0.05);伤口血肿、肌张力升高、下肢感觉异常、下肢运动障碍、下肢静脉血栓发生率低于传统置钉组(P<0.05)。结论 3D打印辅助技术用于先天性脊柱畸形中可有效判断脊柱畸形的特点,从而科学制定手术方案,缩短手术时间、减少围手术期并发症,有利于患者早期康复,有助于提高置钉准确率及主弯矫形率,可降低置钉并发症,值得推广应用。Objective To analyze the comparison of efficacy and the influence of accuracy on 3D printing assistive technolo-gy in patients with congenital spinal deformities.Methods It was retrospectively analyzed the clinical data of 78 patients with con-genital spinaldeformities treated in Qinghai Red Cross Hospital from March 2017 to December 2022.All patients were divided into 3D auxiliary group and treatment group according to therapeutic schedule.All patients were treated with spinal deformity correction.The control group was treated with traditional nail placement technology,while the 3D auxiliary group was treated with 3D printing assistive technology.The patients were followed up for 3 months,comparing the two groups′the related indexes of nail placement,visual ana-logue pain(VAS)score,corrective rate of main curvature,imaging indexes,nail placement accuracy and complications.Results The time of nail placement,bleeding volume,fluoroscopy times and postoperativeVAS score at 7 daysin 3D auxiliary group were lower than those in traditional group(P<0.05).The corrective rate of main cur-vature was higher than that of traditional nailing group(P<0.05).The imaging indexes of both groups were improved at 7 days after op-eration.Coronal Cobb Angle,local kyphosis Angle,C7PL CSVL and SVA levels in 3D auxiliary group were lower than those in traditional nail placement group(P<0.05).The accuracy of nailing in 3D auxiliary group was higher than that in traditional group(P<0.05).The incidence rates of wound hematoma,increased muscle tone,paresthesia,dyskinesia and venous thrombosis of lower extremity were lower than those of traditional nail placement group(P<0.05).Conclusion 3D printing assistive technology can effectively judge the characteristics of spinal deformity in congenital spinal deformity,so as to scientifically formulate surgical plans,shorten the opera-tion time,reduce perioperative complications,conducive to early rehabilitation of patients,help to improve the accuracy of nail place-ment and the corrective rate of

关 键 词：传统置钉技术 3D打印辅助技术 先天性脊柱畸形 准确性 脊柱功能 

分 类 号：R681.5[医药卫生—骨科学]