中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5621-5628.doi: 10.12307/2026.698

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    

3D打印人工椎体在颈椎前路椎体次全切除植骨融合中应用效果的Meta分析

吴荣海1，2，郑周杭1，2，陈  欢1，2，尤冬春1，2，郭伟锋1，2，刘幸明1，2，张  宇1，2   

  1. 1广州中医药大学，广东省广州市  510006；2广东省第二中医院(广东省中医药工程技术研究院)，广东省广州市  510095
  • 接受日期:2025-07-21 出版日期:2026-07-28 发布日期:2026-03-06
  • 通讯作者: 张宇，博士，主任医师，广州中医药大学，广东省广州市 510006；广东省第二中医院(广东省中医药工程技术研究院)，广东省广州市 510095
  • 作者简介:吴荣海，男，1995年生，广东省茂名市人，汉族，2022年广州中医药大学毕业，硕士，中医师，主要从事脊柱退行性病变的研究。
  • 基金资助:
    广东省基础与应用基础研究基金省企联合基金(2022A1515220093)，项目负责人：张宇

Meta-analysis of application effect of 3D-printed artificial vertebral bodies in anterior cervical corpectomy and fusion

Wu Ronghai1, 2, Zheng Zhouhang1, 2, Chen Huan1, 2, You Dongchun1, 2, Guo Weifeng1, 2, Liu Xingming1, 2, Zhang Yu1, 2   

  1. 1Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 2Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology), Guangzhou 510095, Guangdong Province, China
  • Accepted:2025-07-21 Online:2026-07-28 Published:2026-03-06
  • Contact: Zhang Yu, MD, Chief physician, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology), Guangzhou 510095, Guangdong Province, China
  • About author:Wu Ronghai, MS, Physician, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology), Guangzhou 510095, Guangdong Province, China
  • Supported by:
    Guangdong Province Basic and Applied Basic Research Fund Provincial-Enterprise Joint Fund, No. 2022A1515220093 (to ZY)

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摘要：

文题释义：

3D打印人工椎体：是借助3D打印技术，以钛合金为原材料，采用电子熔炉技术在真空环境中打印出形态更加符合患者解剖的植入物。作为一种创新的医疗器械，3D打印人工椎体个性化定制、高精度成型、良好的生物相容性和促进骨融合等优势使得它在临床上具有广泛的应用前景。
颈椎前路椎体次全切除植骨融合：基本原理是通过前路手术入路，切除病变的颈椎椎体或部分椎体，然后进行植骨和融合，以恢复颈椎的稳定性和功能，尤其适用于脊髓型颈椎病、颈椎骨折、颈椎肿瘤等需要切除部分或全部椎体并进行重建的情况。

摘要
目的：近年来，许多学者将3D打印人工椎体应用于颈椎前路椎体次全切除植骨融合术中，但是与传统钛笼相比是否疗效更佳尚存争议。为此，拟系统评价3D打印人工椎体对比传统钛笼作为内植物应用于颈椎前路椎体次全切除植骨融合治疗颈椎病的有效性与安全性。
方法：计算机检索CNKI、WangFang、CBM、VIP、PubMed、EMBASE、The Cochrane Library数据库，搜集各数据库建库至2025年2月有关3D打印人工椎体应用于颈椎前路椎体次全切除植骨融合的临床研究。筛选文献、提取资料并评价纳入研究的方法学质量后，采用Rev Man 5.4软件进行Meta分析。
结果：①共纳入10篇文献，包含2篇前瞻性随机对照研究，6篇回顾性队列研究，2篇前瞻性队列研究，均为高质量研究；所纳入的文献共包含534例患者，其中3D打印组273例，对照组261例；②Meta分析结果显示：3D打印组在手术时间[SMD=-1.13，95%CI
(-1.87，-0.39)，P=0.003]、术后末次随访椎间隙丢失高度[SMD=-3.01，95%CI(-5.74，-0.29)，P=0.03]、术后3个月颈椎功能障碍指数[SMD=-0.34，95%CI(-0.66，-0.03)，P=0.03]、假体塌陷率[OR=0.19，95%CI(0.11，0.32)，P < 0.000 01]、术后吞咽不适发生率[OR=0.43，95%CI(0.21，0.90)，P=0.03]方面均优于对照组，差异有显著性意义；在手术出血量、住院时间、术后日本骨科协会评分、术后目测类比评分、术后颈椎功能障碍指数(术后6个月、末次随访)、椎体融合率方面，两组差异无显著性意义(P > 0.05)。
结论：与传统钛笼相比，3D打印人工椎体在提高手术效率、维持术后椎间隙高度、减少术后吞咽不适发生率及假体塌陷率方面具有明显优势。


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: 颈椎, 3D打印, 人工椎体, 颈椎前路椎体次全切植骨融合, Meta分析

Abstract: OBJECTIVE: In recent years, many scholars have applied 3D-printed artificial vertebrae to anterior cervical vertebral subtotal vertebral resection and bone grafting fusion, but whether it is more effective than traditional titanium cages remains controversial. This study aims to systematically evaluate the effectiveness and safety of 3D-printed artificial vertebrae compared with traditional titanium cages as implants for anterior cervical corpectomy and fusion in the treatment of spondylosis.
METHODS: Databases such as CNKI, WangFang, CBM, VIP, PubMed, EMBASE, and The Cochrane Library were searched to collect the clinical research on the application of 3D-printed artificial vertebrae in anterior cervical corpectomy and fusion from the establishment of each database to February 2025. After screening the literature, extracting the data and evaluating the methodological quality of the included studies, the meta-analysis was performed using Rev Man 5.4.
RESULTS: (1) A total of 10 articles were included, including 2 prospective randomized controlled studies, 6 retrospective cohort studies, and 2 prospective cohort studies all of which were high-quality studies. The included literature comprised a total of 534 patients, including 273 in the 3D printing group and 261 in the control group. (2) The results of the meta-analysis showed that operation time [SMD=-1.13, 95%CI (-1.87, -0.39), P=0.003], the loss of disc height at the last follow-up [SMD=-3.01, 95%CI (-5.74, -0.29), P=0.03], the Neck Disability Index score (postoperative 3 months) [SMD=-0.34, 95%CI(-0.66, -0.03), P=0.03], the prosthesis subsidence rate [OR=0.19, 95%CI (0.11, 0.32), P < 0.000 01], and the incidence of postoperative dysphagia [OR=0.43, 95%CI (0.21, 0.90), P=0.03] were better in the 3D printing group than those in the control group, with significant differences. There was no statistically significant difference in the amount of intraoperative blood loss, hospital stay, postoperative Japanese Orthopaedic Association score, postoperative Visual Analog Scale score, postoperative Neck Disability Index score (6 months after surgery, at the last follow-up), and the rate of vertebral fusion between the two groups (P > 0.05). 
CONCLUSION: Compared with traditional titanium cages, 3D-printed artificial vertebrae have obvious advantages in improving surgical efficiency, maintaining postoperative intervertebral height, reducing the incidence of postoperative swallowing discomfort and titanium cage subsidence. 

Key words: cervical vertebra, 3D printing, artificial vertebra, anterior cervical corpectomy and fusion, meta-analysis

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