中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (30): 4806-4811.doi: 10.12307/2024.634

• 数字化骨科 digital orthopedics • 上一篇    下一篇

3D打印脊柱侧弯矫形器治疗青少年脊柱侧弯的多准则决策模型评价

张鸿生1，黄汉伟2，王金武3，郑俊伟4，刘日新1，廖梓杰1，王  鹏1， 许苑晶5，王赞博6，万克明6   

  1. 中山陈星海中西医结合医院，1骨科，2内分泌科，4康复科，广东省中山市   528415；3上海交通大学医学院附属第九人民医院骨科，上海市   200000；5上海交通大学生物医学工程学院，上海市   200000；6上海交通大学转化医学研究院，上海市   201100
  • 收稿日期:2023-06-20 接受日期:2023-08-21 出版日期:2024-10-28 发布日期:2023-12-25
  • 作者简介:张鸿生，男，1982年生，广东省普宁市人，汉族，副主任中医师，主要从事骨科方面的研究。
  • 基金资助:
    中山市科学技术局项目(2022B1055)，项目负责人：张鸿生

Multi-criteria decision model in treatment of adolescent scoliosis with three-dimensional printed scoliosis orthosis

Zhang Hongsheng1, Huang Hanwei2, Wang Jinwu3, Zheng Junwei4, Liu Rixin1, Liao Zijie1, Wang Peng1, Xu Yuanjing5, Wang Zanbo6, Wan Keming6   

  1. 1Department of Orthopedics, 2Department of Endocrinology, 4Department of Rehabilitation, Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine, Zhongshan 528415, Guangdong Province, China; 3Department of Orthopedics, The Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China; 5School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200000, China; 6Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai 201100, China
  • Received:2023-06-20 Accepted:2023-08-21 Online:2024-10-28 Published:2023-12-25
  • About author:Zhang Hongsheng, Associate chief physician, Department of Orthopedics, Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine, Zhongshan 528415, Guangdong Province, China
  • Supported by:
    Zhongshan Science and Technology Bureau, No. 2022B1055 (to ZHS)

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摘要：


文题释义：

3D 打印技术：是一种利用计算机辅助设计、数控技术、三维 CT 技术等快速成型技术，将数据立体化建模，并运用粉末状的金属或塑料等可黏合材料逐层融合叠加，最终打印出三维实物模型的技术。
青少年特发性脊柱侧弯：是脊柱的三维畸形，在10岁或以后被发现，表现为脊柱侧弯、椎骨旋转以及额状面的柔性或刚性畸形。


背景：传统脊柱侧弯矫形器存在制作工艺流程复杂、加工周期长、贴合性差等缺点，3D打印脊柱侧弯矫形器具有制造精度高、个性化等优势。

目的：基于多准则决策模型评价3D打印脊柱侧弯矫形器治疗脊柱侧弯的疗效。
方法：回顾性收集2019年1月至2022年10月收治于中山陈星海中西医结合医院的72例脊柱侧弯患者的临床资料，根据治疗矫形器的不同分为2组，研究组23例采用3D打印脊柱侧弯矫形器治疗，传统组49例采用传统的聚丙烯脊模塑柱矫形器治疗。比较两组患者临床疗效以及并发症发生状况；建立3D打印脊柱侧弯矫形器治疗脊柱侧弯的多准则决策模型，并对两组效益值、风险值及决策模型的稳定性进行评价。

结果与结论：①研究组患者治疗6个月后，顶椎偏移距离、Cobb角、顶椎旋转度、功能性运动评分、目测类比评分以及总有效率与传统组相比均显著改善，差异有显著性意义(P < 0.05)；②效益指标中对患者病情影响最大的是Cobb角，风险指标影响较大的是呼吸困难；③研究组和传统组治疗脊柱侧弯效益值分别为79和64，风险值分别为74和57，综合效益和风险值发现研究组治疗方法的效益-风险值比传统组高出16；④在0-100%风险相对权重范围内，研究组的效益-风险总值总是高于传统组，证明多准则决策模型的稳定性较好；⑤提示3D打印脊柱矫形器能够更好地恢复脊柱侧弯青少年的脊柱生理弯曲，提高治疗有效率。

https://orcid.org/0009-0009-6267-3810 (张鸿生) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 3D打印, 脊柱侧弯矫形器, 青少年脊柱侧弯, 疗效, 多准则决策模型

Abstract: BACKGROUND: Traditional scoliosis orthosis has some disadvantages, such as complex manufacturing process, long processing cycle, poor fit and so on. Three-dimensional printed scoliosis orthosis has the advantages of high manufacturing precision and personalization.
OBJECTIVE: To evaluate the efficacy of three-dimensional printed scoliosis orthosis for scoliosis based on multi-criteria decision model. 
METHODS: Clinical data of 72 patients with scoliosis admitted to Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to October 2022 were retrospectively collected and divided into two groups according to the treatment of orthosis. Study group (n=23) received three-dimensional printed scoliosis orthosis. Traditional group (n=49) received the traditional polypropylene spine brace treatment. The clinical efficacy and complications were compared between the two groups. A multi-criteria decision model for the treatment of scoliosis with three-dimensional printed scoliosis orthosis was established, and the stability of the benefit value, risk value and decision model of the two groups were evaluated. 
RESULTS AND CONCLUSION: (1) Compared with the traditional group, there were significant differences in the top vertebral offset distance, Cobb angle, top vertebral rotation, Functional Movement Screen score, visual analog scale score and total effective rate in the study group at 6 months after surgery (P < 0.05). (2) Among the benefit indexes, Cobb angle had the greatest impact on the condition of patients, while the risk indexes had the greatest impact on dyspnea. (3) The benefit values of the study group and the traditional group for scoliosis were 79 and 64, and the risk values were 74 and 57, respectively. The combined benefit and risk values found that the benefit-risk value of the study group was 16 higher than that of the traditional group. (4) In the range of 0-100% relative risk weight, the benefit-risk value of the study group was always higher than that of the traditional group, which proved that the multi-criteria decision-making model had good stability. (5) It is indicated that three-dimensional printed scoliosis orthosis can better restore the physiological curvature of scoliosis and improve the efficiency of treatment.

Key words: three-dimensional printing, scoliosis orthosis, adolescent scoliosis, curative effect, multi-criteria decision model

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