| 基于3D打印技术改良单边经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折 |
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投稿时间：2023-05-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 蒋维利 |
JIANG Wei-li |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 刘涛 |
LIU Tao |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 张青波 |
ZHANG Qing-bo |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 陈辉 |
CHEN Hui |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 白建中 |
BAI Jian-zhong |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 王帅 |
WANG Shuai |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 程嘉伟 |
CHENG Jia-wei |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 郭亚龙 |
GUO Ya-long |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 周功 |
ZHOU Gong |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
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| 牛国旗 |
NIU Guo-qi |
蚌埠医学院第二附属医院脊柱外科, 安徽 蚌埠 233002 |
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China |
ssngq@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第1期，第7-14页 |
| DOI：10.12200/j.issn.1003-0034.20221151 |
| 基金项目:蚌埠医学院自然科学基金(编号:2021byzd199);蚌埠医学院科研创新团队项目(编号:BYKC201911);蚌埠医学院第二附属医院数字骨科重点实验室立项建设项目[编号:校字(2019)160号] |
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中文摘要:
目的:探讨结合3D打印技术改良单边经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)治疗胸腰椎压缩性骨折的临床疗效。
方法:自2020年10月至2022年4月收治77例骨质疏松性胸腰椎压缩性骨折患者,均为外伤导致的椎体压缩性骨折。根据治疗方法不同分为试验组和对照组。试验组32例采用3D打印技术改良单边经椎弓根穿刺椎体成形术,男5例,女27例,年龄63~91(77.59±8.75)岁;对照组45例采用传统双边经椎弓根穿刺椎体成形术治疗,男7例,女38例,年龄60~88(74.89±7.37)岁。记录并比较两组手术时间,术中C形臂X线机透视次数,麻醉药用量,骨水泥注入量,骨水泥的弥散优良率,并发症,术前及术后1、6个月椎体高度,脊柱后凸角度(Cobb角),疼痛视觉模拟评分(visual analogue scale,VAS)、功能障碍指数(Oswestry disability index,ODI)等指标。
结果:所有患者获得随访,时间6~23个月。术前影像学检查,均证实为胸腰椎骨质疏松压缩性骨折,两组骨水泥注入量、骨水泥弥散率、术前及术后椎体高度、Cobb角、VAS、ODI比较,差异均无统计学意义(P>0.05)。两组手术时间、术中透视次数、麻醉药用量比较,差异有统计学意义(P<0.05)。两组术后各时间点患椎椎体前缘高度、Cobb角、VAS、ODI与术前比较,差异有统计学意义(P<0.05)。
结论:骨质疏松性胸腰椎压缩性骨折采用3D打印技术改良单边穿刺PVP治疗,穿刺方便简单,创伤更小,手术时间短,透视次数较少,骨水泥分布满意、椎体高度恢复及后凸角度矫正较好,功能改善良好。 |
| 【关键词】椎体成形术 3D打印技术 骨质疏松性骨折 |
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| Improved unilateral puncture PVP based on 3D printing technology for the treatment of osteoporotic vertebral compression fracture |
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ABSTRACT
Objective To investigate the clinical effect of unilateral percutaneous vertebroplasty (PVP) combined with 3D printing technology for the treatment of thoracolumbar osteoporotic compression fracture.
Methods A total of 77 patients with thoracolumbar osteoporotic compression fractures from October 2020 to April 2022 were included in the study,all of which were vertebral body compression fractures caused by trauma. According to different treatment methods,they were divided into experimental group and control group. Thirty-two patients used 3D printing technology to improve unilateral transpedicle puncture vertebroplasty in the experimental group,there were 5 males and 27 females,aged from 63 to 91 years old with an average of (77.59±8.75) years old. Forty-five patients were treated with traditional bilateral pedicle puncture vertebroplasty,including 7 males and 38 females,aged from 60 to 88 years old with an average of(74.89±7.37) years old. Operation time,intraoperative C-arm X-ray times,anesthetic dosage,bone cement injection amount,bone cement diffusion good and good rate,complications,vertebral height,kyphotic angle (Cobb angle),visual analogue scale(VAS),Oswestry disability index (ODI) and other indicators were recorded before and after surgery,and statistically analyzed.
Results All patients were followed up for 6 to 23 months,with preoperative imaging studies,confirmed for thoracolumbar osteoporosis compression fractures,two groups of patients with postoperative complications,no special two groups of patients' age,gender,body mass index (BMI),time were injured,the injured vertebral distribution had no statistical difference(P>0.05),comparable data. Two groups of patients with bone cement injection,bone cement dispersion rate,preoperative and postoperative vertebral body height,protruding after spine angle(Cobb angle),VAS,ODI had no statistical difference(P>0.05). The operative time,intraoperative fluoroscopy times and anesthetic dosage were statistically different between the two groups(P<0.05). Compared with the traditional bilateral puncture group,the modified unilateral puncture group combined with 3D printing technology had shorter operation time,fewer intraoperative fluoroscopy times and less anesthetic dosage. The height of anterior vertebral edge,kyphosis angle (Cobb angle),VAS score and ODI of the affected vertebrae were statistically different between two groups at each time point after surgery(P<0.05).
Conclusion In the treatment of thoracolumbar osteoporotic compression fractures,3D printing technology is used to improve unilateral puncture PVP,which is convenient and simple,less trauma,short operation time,fewer fluoroscopy times,satisfactory distribution of bone cement,vertebral height recovery and kyphotic Angle correction,and good functional improvement. |
| KEY WORDS Vertebroplasty 3D printing technology Osteoporotic fracture |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蒋维利,刘涛,张青波,陈辉,白建中,王帅,程嘉伟,郭亚龙,周功,牛国旗.基于3D打印技术改良单边经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折[J].中国骨伤,2024,37(1):7~14 |
| 英文格式: | JIANG Wei-li,LIU Tao,ZHANG Qing-bo,CHEN Hui,BAI Jian-zhong,WANG Shuai,CHENG Jia-wei,GUO Ya-long,ZHOU Gong,NIU Guo-qi.Improved unilateral puncture PVP based on 3D printing technology for the treatment of osteoporotic vertebral compression fracture[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(1):7~14 |
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