3D打印钛合金椎间融合器联合含PRP同种异体骨在ACDF中的应用效果  

Effect of 3D printed titanium interbody fusion device combined with PRP-containing allograft bone in ACDF surgery

作　　者：王路 李贤海 刘宪翠 徐浩 张亮[2] WANG Lu;LI Xianhai;LIU Xiancui;XU Hao;ZHANG Liang(Department of Orthopaedics,Zhoushan Hospital Affiliated to Wenzhou Medical University,Zhoushan,Zhejiang 316000,China;不详)

机构地区：[1]温州医科大学附属舟山医院骨科,浙江舟山316000 [2]浙江中医药大学附属杭州市中医院骨伤科,浙江杭州310006

出　　处：《中华全科医学》2024年第7期1133-1137,1174,共6页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2020ZB163);浙江省舟山科技局项目(2023C31009)。

摘　　要：目的分析3D打印钛合金椎间融合器与富血小板血浆(PRP)处理的同种异体骨联合应用于颈前路椎间盘切除融合术(ACDF)的临床效果,以及其在促进脊柱稳定性和椎体融合中的潜在效益。方法选取2021年8月—2023年5月温州医科大学附属舟山医院收治的需行ACDF的颈椎病患者110例,其中56例采用3D打印钛合金椎间融合器加同种异体骨的患者为A组,54例采用3D打印钛合金椎间融合器联合含PRP同种异体骨的患者为B组。观察2组手术时间、术中出血量、术后引流量、日本骨科协会(JOA)评分、视觉模拟疼痛(VAS)评分,测量节段性前凸角(SA)、颈椎曲度指数(CCI)、椎间盘高度(IH)以及术后各时间点的融合率。结果2组手术时间、术中出血量比较差异均无统计学意义(P>0.05),B组术后引流量明显少于A组(P<0.05);不同时间点VAS评分、JOA评分差异有统计学意义(P<0.05);不同时间点SA、CCI、IH差异均有统计学意义(P<0.05);颈椎正侧位X片显示,A、B组术后3个月影像学融合率分别为48.21%(27/56)、70.37%(38/54),术后6个月影像学融合率分别为73.21%(41/56)、92.59%(50/54),术后12个月融合率均为100.00%,B组术后3个月、6个月随访融合率明显高于A组(P<0.05)。结论ACDF中采用3D打印钛合金椎间融合器联合含PRP同种异体骨具有术后引流量少的优点,还可以促进早期融合,提高融合手术成功率,有益于患者术后早期康复。Objective This study analyzes the clinical outcomes of the combined application of 3D-printed titanium alloy intervertebral fusion devices and autologous bone treated with platelet-rich plasma(PRP)in anterior cervical discectomy and fusion(ACDF)procedures.It further assesses the potential benefits of this combination in promoting spinal stability and vertebral fusion.Methods From August 2021 to May 2023,110 patients with cervical spondylosis who needed ACDF were selected.Among them,56 patients with 3D printed interbody fusion cage were classified as Group A,and 54 patients with 3D printed interbody fusion cage combined with PRP allograft were classified as Group B.The operation time,intraoperative blood loss,postoperative drainage,Japanese Orthopedic Association(JOA)score,and visual simulated pain(VAS)score were observed,and the segmental angle(SA),cervical curvature index(CCI),intervertebral disc height(IH)and the fusion rate at each time point after operation were measured.Results There was no significant difference in operation time and blood loss between the two groups(P>0.05),and the postoperative drainage in group B was significantly less than that in group A(P<0.05).There were statistical differences in VAS score and JOA score evaluated at different times(P<0.05).There were statistical differences in SA,CCI,and IH measured at different times(P<0.05).The X-ray of the cervical spine showed that the imaging fusion rates of group A and group B were 48.21%(27/56)and 70.37%(38/54)at 3 months after operation,73.21%(41/56)and 92.59%(50/54)at 6 months after operation,and 100.00%at 12 months after operation.The fusion rates of group B at 3 months and 6 months after operation were significantly higher than those of group A(P<0.05).Conclusion The use of a 3D printed interbody fusion cage combined with PRP-containing allogenic bone in ACDF has the advantage of less postoperative drainage,which can also promote early fusion and improve the success rate of fusion surgery.

关 键 词：颈椎病 3D打印钛合金椎间融合器 富血小板血浆 同种异体骨 颈前路椎间盘切除融合术 临床疗效 

分 类 号：R681.55[医药卫生—骨科学] R687.4[医药卫生—外科学]