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

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

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。

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.