颈前路椎体次全切融合术中应用3D打印椎体与纳米羟基磷灰石/聚酰胺66椎体的早期临床疗效比较  

Comparison of early clinical efficacy of 3D-printed vertebral body and nano hydroxyapatite/polyamide 66 strut in anterior cervical corpectomy and fusion

作　　者：岳玺 武金亮 杨科荣 宋瑞鹏[1] 谭洪宇[1] Yue Xi;Wu Jinliang;Yang Kerong;Song Ruipeng;Tan Hongyu(Department of Orthopaedics,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450052

出　　处：《中华实验外科杂志》2024年第2期386-389,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨3D打印椎体与纳米羟基磷灰石/聚酰胺66(n-HA/PA66)椎体对颈前路椎体次全切融合术(ACCF)术后颈椎矢状面影响及早期临床疗效。方法收集2020年6月至2022年1月在郑州大学第一附属医院开展ACCF的患者共56例, 其中应用3D打印椎体(3D组)28例, n-HA/PA66椎体(n-HA/PA66组)28例, 比较两组患者术前一般资料, 术后临床和影像学指标。结果 3D组术后3、6、12、18个月C2~7 Cobb高于n-HA/PA66组(19.42±3.20比17.71±2.50、18.71±3.15比17.04±1.94、18.49±3.13比16.86±2.17、18.32±2.89比16.40±1.48, t=-2.233、-2.385、-2.267、-3.121, P<0.05), 3D组术后3、6、12、18个月C2~7 SVA低于n-HA/PA66组(14.52±2.45比16.88±2.50、14.74±2.21比17.30±3.86、14.81±2.28比17.38±3.91、15.27±2.23比17.84±3.76, t=2.595、3.052、3.004、3.107, P<0.05), 3D组术后3、6、12、18个月T1倾斜角高于n-HA/PA66组(24.11±2.88比21.47±2.11、23.15±2.67比20.46±2.02、23.23±2.70比20.64±2.08、22.58±2.44比20.04±2.02, t=-3.912、-4.257、-4.011、-4.253, P<0.05), 3D组术后3个月融合率高于n-HA/PA66组[82.1%(46/56)比65.5%(36/56), χ^(2)=4.004, P<0.05], 3D组术后12、18个月下沉率低于n-HA/PA66组[5.4%(3/56)比21.4%(12/56)、7.1%(4/56)比25.0%(14/56), χ^(2)=6.235、6.619, P<0.05]。结论 3D打印椎体和n-HA/PA66椎体应用于ACCF都可取得良好的早期临床效果, 但3D打印椎体在椎体融合速度、维持生理曲度和减缓沉降方面更具优势。Objective To compare the cervical sagittal balance and clinical effect between 3D-printed vertebral body and nano hydroxyapatite/polyamide 66(n-HA/PA66)strut after anterior cervical corpectomy and fusion(ACCF).Methods A retrospective analysis was performed on 56 patients who underwent ACCF in First Affiliated Hospital of Zhengzhou University from June 2020 to January 2022.Among them,28 patients underwent 3D printed vertebral body fusion(3D group).A total of 28 patients underwent n-HA/PA66 strut fusion(n-HA/PA66 group).Preoperative general data,postoperative clinical and radiological parameters of the two groups were analyzed.Results C2-7 Cobb in 3D group was higher than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(19.42±3.20 vs.17.71±2.50,18.71±3.15 vs.17.04±1.94,18.49±3.13 vs.16.86±2.17,18.32±2.89 vs.16.40±1.48,t=-2.233,-2.385,-2.267,-3.121,P<0.05).C2-7SVA in 3D group was lower than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(14.52±2.45 vs.16.88±2.50,14.74±2.21 vs.17.30±3.86,14.81±2.28 vs.17.38±3.91,15.27±2.23 vs.17.84±3.76,t=2.595,3.052,3.004,3.107,P<0.05).The inclination of T1 in 3D group was higher than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(24.11±2.88 vs.21.47±2.11,23.15±2.67 vs.20.46±2.02,23.23±2.70 vs.20.64±2.08,22.58±2.44 vs.20.04±2.02,t=-3.912,-4.257,-4.011,-4.253,P<0.05).The fusion rate at 3rd month after surgery in the 3D group was higher than that in the n-HA/PA66 group[82.1%(46/56)vs.65.5%(36/56),χ^(2)=4.004,P<0.05].The subsidence rate at 12,18 months after surgery in the 3D group was lower than that in the n-HA/PA66 group[5.4%(3/56)vs.21.4%(12/56),7.1%(4/56)vs.25.0%(14/56),χ^(2)=6.235,6.619,P<0.05].Conclusion Both 3D printed vertebrae and n-HA/PA66 strut can achieve good early clinical results in ACCF,but 3D printed vertebrae have more advantages in interbody fusion speed,maintaining physiological curvature and slowing down settlement.

关 键 词：3D打印椎体 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]