快速成型模型佐助胸腰椎椎弓根置钉的研究

Application of transpedicular screw placement assisted by rapid prototyping technology in the thoracic and lumbar spines

目的探讨快速成型技术佐助胸腰椎椎弓根螺钉置入的准确性和可靠性。方法将患者分成两组,快速成型组26例,传统手法置钉组26例,由同一位医师分别采用快速成型模型佐助置钉法和传统手法置钉进行胸腰椎椎弓根螺钉置入。术后CT扫描比较两种方法的置钉准确性。结果快速成型模型佐助置钉156枚,其中3枚穿破皮质,成功率98.08%,绝对风险率0.64%;传统手法置钉121枚,11枚穿破皮质,成功率90.91%,绝对风险率4.13%。两组病例均未出现神经血管损伤并发症,快速成型佐助置钉法准确率明显高于传统手法置钉,安全性提高,差异具有统计学意义(P<0.05)。结论快速成型模型佐助胸腰椎椎弓根置钉,可提高准确率和安全性,操作简单,符合个体化置钉,为胸腰椎椎弓根螺钉置入提供一种新方法。

Objective To discuss on rapid prototyping technology assisted thoracic and lumbar pedicle screw placement accuracy and feasibility. Methods The patients, were divided into two groups of rapid prototyping group of 26 cases,the traditional manual nailing group 26 cases,by the same physicians using rapid prototyping aided placement method and the traditional manual placement of thoracic lumbar pedicle screw placement. Postoperative CT scans compare the two methods of pedicle screw accuracy. Results Rapid prototyping assisted pedicle screw 156,in which 3 per-foration of the cortex,the success rate of 98.08% ,absolute risk rate：0.64% ,traditional methods set screw 121,11 perforation of the cortex,the success rate of 90.9%. absolute risk rate 4.13% Two cases had no neurological complications or vascular injury,rapid prototyping method assisted pedicle screw accuracy of pedicle screws was significantly higher than traditional methods,security was greatly improved,the difference was statistically significant（P〈0.05）. Conclusion Rapid prototyping technology-assisted thoracic and lumbar pedicle screw is safe and reliable, simple operation,high accuracy of pedicle screws,with individual screw insertion,for thoracic and lumbar pedicle screw placement with a new method.