3D打印辅助与经后路椎弓根钉棒内固定治疗强直性脊柱炎并胸腰椎骨折的比较

发布时间：2018-04-24 23:29

本文选题：D打印技术 + 经后路椎弓根钉棒　；参考：《中国矫形外科杂志》2017年23期

【摘要】：[目的]比较3D打印辅助与常规经后路椎弓根钉棒内固定治疗强直性脊柱炎并胸腰椎骨折的疗效。[方法]回顾性分析本院86例强直性脊柱炎并胸腰椎骨折患者病例,依据治疗方法分为2组,每组43例。常规组给予CT、X线辅助经后路椎弓根钉棒内固定,3D打印组给予3D打印辅助经后路椎弓根钉棒内固定。比较两组围术期指标、JOA评分、置钉情况、伤椎复位指标、并发症情况。[结果]3D打印组手术时间、术中出血量、术中X线暴露次数、术中输血量明显低于常规组(P0.05)。术后1 d、1周、半年、1年时,3D打印组患者的JOA评分均明显高于常规组(P0.05)。治疗后,3D打印组置钉准确率为95.37%,明显高于常规组的74.89%(P0.05)。治疗后,两组伤椎前后缘高度比均明显升高,矢状位后凸Cobb角均明显下降(P0.05);且治疗后半年、1年时3D打印组伤椎前后高度比明显高于常规组(P0.05),矢状位后凸Cobb角明显低于常规组(P0.05)。3D打印组并发症率为2.33%,低于常规组的11.63%(P0.05)。[结论]相比于常规经后路椎弓根钉棒内固定,3D打印辅助可有效治疗强直性脊柱炎并胸腰椎骨折,具有手术时间短、出血量少、X线暴露次数少、术后恢复快等优点。
[Abstract]:[objective] to compare the efficacy of 3D print assisted and conventional posterior pedicle screw rod fixation in the treatment of ankylosing spondylitis with thoracolumbar fractures. [methods] 86 cases of ankylosing spondylitis complicated with thoracolumbar fracture were analyzed retrospectively. The routine group was treated with CTT X ray assisted posterior pedicle screw rod fixation and the 3D printing group was treated with 3D print assisted posterior pedicle screw rod internal fixation. JOA score, nailing, reduction index and complications were compared between the two groups. [results] the time of operation, the amount of intraoperative bleeding, the times of X-ray exposure and the volume of blood transfusion in 3D printing group were significantly lower than those in routine group (P 0.05). The JOA scores in the 3D printing group were significantly higher than those in the routine group at 1 week, 6 months and 1 year postoperatively. After treatment, the accuracy of nail placement in 3D printing group was 95.37, which was significantly higher than that in routine group (74.89) (P0.05). After treatment, the ratio of anterior and posterior edge height of the injured vertebrae in both groups was significantly higher than that in the control group. The Cobb angle of sagittal kyphosis decreased significantly (P 0.05), and the ratio of anterior and posterior height of injured vertebrae in 3D printing group was significantly higher than that in routine group at 1 year after treatment, and the Cobb angle of sagittal kyphosis was significantly lower than that in routine group (P 0.05), and the complication rate was 2.33%, lower than that in routine group (11.63% P 0.05). [conclusion] compared with conventional posterior pedicle screw and rod internal fixation, 3D printing can effectively treat ankylosing spondylitis with thoracolumbar fracture. It has the advantages of short operation time, less bleeding, less X-ray exposure, and quick recovery after operation.
【作者单位】：承德医学院附属医院脊柱外科;
【分类号】：R687.3

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