中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (53): 7966-7972.doi: 10.3969/j.issn.2095-4344.2016.53.009

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

基于3D打印模型确定经椎弓根椎体截骨治疗脊柱后凸畸形的最佳选择

张树芳,钟红发,陈荣春,郭朝阳,叶书熙,游 辉   

  1. 南昌大学附属赣州医院脊柱外科,江西省赣州市 341000
  • 修回日期:2016-11-02 出版日期:2016-12-23 发布日期:2016-12-23
  • 通讯作者: 钟红发,副主任医师,南昌大学附属赣州医院脊柱外科,江西省赣州市 341000
  • 作者简介:张树芳,男,1983年生,江西省赣州市人,2012年南方医科大学毕业,博士,主治医师,主要从事脊柱外科工作。
  • 基金资助:

    江西省卫计委课题(20157172)

Best choice of three-dimensional printing-assisted pedicle subtraction osteotomy for the treatment of kyphosis deformity

Zhang Shu-fang, Zhong Hong-fa, Chen Rong-chun, Guo Zhao-yang, Ye Shu-xi, You Hui   

  1. Department of Spinal Surgery, Ganzhou Hospital Affiliated to Nanchang University, Ganzhou 341000, Jiangxi Province, China
  • Revised:2016-11-02 Online:2016-12-23 Published:2016-12-23
  • Contact: Zhong Hong-fa, Associate chief physician, Department of Spinal Surgery, Ganzhou Hospital Affiliated to Nanchang University, Ganzhou 341000, Jiangxi Province, China
  • About author:Zhang Shu-fang, M.D., Attending physician, Department of Spinal Surgery, Ganzhou Hospital Affiliated to Nanchang University, Ganzhou 341000, Jiangxi Province, China
  • Supported by:

     the Health and Family Planning Commission of Jiangxi Province, No. 20157172

摘要:

文章快速阅读:

 

 

文题释义:
3D 打印:内固定前对患者进行CT扫描,获得相关数据,打印出脊柱后凸模型。在传统的脊柱后凸矫形中,脊柱外科医师是通过内固定前X射线和CT进行规划矫形效果。通过3D打印技术,脊柱外科医师可以通过模拟真实的环境中进行模拟矫形手术及矫形后结果预测,从而减少手术时间和手术并发症。
经椎弓根椎体截骨:通过切除脊柱后方椎板、椎弓根,能对后柱软组织进行松解、病灶椎体施行“V”形切除,同时能通过闭合后方可实现前中柱的骨性接触及后凸矫正,手术通过经椎弓根区域对椎体进行楔形截骨,以前柱为支点的三柱截骨矫形减少了对脊柱前方血管和内脏的牵拉,同时更大的截骨面使矫形效果更佳,闭合后也利于骨性融合。
 
摘要
背景:术前通过3D 打印技术进行规划和手术设计已经成为临床手术的发展趋势之一,在骨盆骨折、肿瘤切除等方向取得良好的效果,但应用于脊柱后凸畸形截骨的术前设计报道还很少。
目的:探讨脊柱后凸畸形患者术前采用3D打印仿真脊柱后凸型体外模拟截骨治疗脊柱后凸畸形的临床疗效。
方法:回顾性分析2014年6月至2015年6月的40例脊柱后凸畸形患者资料,随机等分为2组。3D打印组行3D打印技术辅助经椎弓根椎体截骨,对照组行经椎弓根椎体截骨。

结果与结论:3D打印组手术时间、出血量、放射显露时间明显低于对照组,矫正率明显高于对照组,并且2组患者目测类比评分和Oswestry残疾指数均低于术前。说明基于3D打印技术的经椎弓根椎体截骨治疗脊柱后凸畸形具有可行性,矫形效果良好,可以减少手术时间及出血量。

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
ORCID:
0000-0002-2948-4489(张树芳)

关键词: 骨科植入物, 脊柱植入物, 脊柱后凸, 经椎弓根截骨, 3D打印, 腰椎, 准确性

Abstract:

BACKGROUND: Three-dimensional (3D) printing for preoperative planning has been gaining popularity at present. 3D printing has been frequently used in bone tumor resection and pelvic fracture surgery, but seldom used in kyphosis deformity.

OBJECTIVE: To evaluate the clinical effect of 3D printing-assisted pedicle subtraction osteotomy for the treatment of kyphosis deformity.
METHODS: Data of 40 patients with kyphosis deformity from June 2014 to June 2015 were retrospectively analyzed. All patients were randomly assigned to two groups. Patients in the 3D printing group underwent 3D printing-assisted pedicle subtraction osteotomy. Patients in the control group underwent pedicle vertebral osteotomy.
RESULTS AND CONCLUSION: Operation time, blood loss and radiation exposure time were significantly lower in the 3D printing group than in the control group, but correction rate was obviously higher in the 3D printing group than in the control group. Visual analog scale scores and Oswestry disability index in both groups were lower after surgery compared with that before surgery. These findings suggested that 3D printing-assisted pedicle subtraction osteotomy is feasible for treatment of spinal kyphosis. The orthopedic effect is good. It can reduce the operation time and blood loss. 

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

Key words: Spina Kyphosis, Internal Fixators, Computer-Aided Design, Follow-Up Studies, Tissue Engineering

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