3D打印导板辅助后路腰椎椎板减压植骨融合内固定术治疗退行性脊柱侧弯的临床疗效  

Clinical efficacy of 3D-printed guide plate-assisted posterior lumbar laminectomy and bone graft fusion with internal fixation in treatment of degenerative scoliosis

作　　者：李亮 赵晶 黄浩然 周政纲 沈世彬 王宾 牛涛 杨孝军 丁坤 LI Liang;ZHAO Jing;HUANG Haoran;ZHOU Zhenggang;SHEN Shibin;WANG Bin;NIU Tao;YANG Xiaojun;DING Kun(不详;Department of Spine Surgery,Chengyang District People's Hospital of Qingdao,Qingdao,Shandong 266109,China)

机构地区：[1]青岛市城阳区人民医院脊柱外科,山东266109 [2]青岛市东部市立医院骨关节外科病区,山东266000 [3]莱西市第三人民医院骨科,山东青岛266600

出　　处：《中国骨与关节损伤杂志》2024年第9期913-918,共6页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察3D打印导板辅助后路腰椎椎板减压植骨融合内固定手术治疗退行性脊柱侧弯的效果。方法回顾性分析自2018-07—2020-10行后路腰椎椎板减压植骨融合内固定手术治疗的47例退行性脊柱侧弯,根据术中置钉方式不同,分为打印组(n=25,采用3D打印导板辅助下置钉)与传统组(n=22,采用传统手动置钉)。比较两组术中置钉时间、置钉透视次数、置钉出血量、置钉调整次数、置钉数量、置钉等级,以及术后置钉可接受率、置钉准确率、置钉并发症发生率及主弯矫正率。结果所有患者均获得随访,随访时间12~18个月,平均14.5个月。打印组术中置入的椎弓根钉直径、长度和外展角度与术前统计记录比较差异无统计学意义(P>0.05)。打印组术中置钉时间、置钉透视次数、置钉出血量及置钉调整次数明显少于传统组,打印组置钉等级情况、置钉准确率、置钉可接受率优于传统组,差异均有统计学意义(P<0.05)。两组术后置钉并发症发生率、主弯矫正率差异无统计学意义(P>0.05)。结论3D打印导板辅助后路腰椎椎板减压植骨融合内固定手术治疗退行性脊柱侧弯的效果满意,不仅可以达到精准置钉、矫正侧弯畸形的目的,而且可显著提高置钉的精准度、优化手术操作、降低手术难度、减少放射源性伤害及出血量,更能保证手术的效率及安全。Objective To observe the clinical efficacy of 3D-printed guide plate-assisted posterior lumbar laminectomy and bone graft fusion with internal fixation surgery,assisted by 3D-printed guide plates,in the treatment of degenerative scoliosis.Methods A retrospective analysis was conducted on 47 cases of degenerative scoliosis who underwent 3D-printed guide plate-assisted posterior lumbar laminectomy and bone graft fusion with internal fixation surgery between July 2018 and October 2020.The patients were categorized into two groups based on the method of intraoperative screw placement:the printing group(n=25,with 3D-printed guide plates utilized for screw placement)and the traditional group(n=22,with screws manually placed).The intraoperative screw placement time,number of fluoroscopy exposures,blood loss,number of screw adjustments,number of screws placed,and screw grades were compared between the two groups,along with the postoperative screw acceptance rate,accuracy rate,complication rate,and main curve correction rate.Results All patients were followed up for 12 to 18 months,with an average of 14.5 months.No statistically significant differences were found in the diameter,length,and lateral angle of the pedicle screws placed intraoperatively in the printing group compared to the preoperative statistical records(P>0.05).The printing group experienced significantly reduced intraoperative screw placement time,number of fluoroscopy exposures,blood loss,and number of screw adjustments compared to the traditional group.The printing group also demonstrated superior screw grading,accuracy rate,and acceptance rate,with statistically significant differences(P<0.05).No statistically significant differences were observed in the postoperative screw complication rate and main curve correction rate between the two groups(P>0.05).Conclusion The 3D-printed guide plate-assisted posterior lumbar laminectomy and bone graft fusion with internal fixation surgery,assisted by 3D-printed guide plates,for the treatment of degenerative scoli

关 键 词：脊柱侧弯 3D打印导板 腰椎管狭窄 内固定 减压融合 

分 类 号：R681.5[医药卫生—骨科学]