3D打印个体化导板与计算机三维导航系统在腰椎椎弓根置钉中的比较

Comparison of 3D printing individual template technique and computer-assisted 3D navigation system in the lumbar pedicle screw placement

目的:比较3D打印个体化导板与计算机三维导航系统在辅助腰椎椎弓根钉置入中的准确性及临床应用价值。方法:2015年6月至2016年6月行腰椎后路椎弓根钉内固定术治疗的32例腰椎病变患者,随机分为3D打印单椎体双侧桥式导板组(导板组)和电动C型臂术中计算机三维导航组(导航组)。比较两组患者在置钉准确率、单枚螺钉平均置入时间、单枚螺钉平均透视频次方面是否有差异。结果:全部病例均获随访,导航组在置钉准确率、单枚螺钉平均置入时间、单枚螺钉平均透视频次方面高于导板组(P<0.05)。结论:电动C型臂术中计算机三维导航在提高腰椎椎弓根置钉准确性方面更好,3D打印单椎体双侧桥式导板在减少置钉时间和术中射线暴露方面具有优势,相比而言,导航法在辅助腰椎椎弓根置钉中具有更高的临床应用价值。

Objective：To compare the accuracy and clinical application value between three-dimensional （3D） printing individual template and computer - assisted 3D navigation system in the assist of lumbar pedicle screw placement. Method：32 cases of lumbar Lesion patients undergoing lumbar posterior pedicle screw fixation from June 2015 to June 2016 were selected and divided, according to the principle of random control, into the 3D printing single vertebral bilateral bridge type template group and electric C - arm computer - assisted 3D navigation system group. The accuracy of screw placement, the average placement time of the single screw, the average fluoroscopic frequency of the single screw were compared in the two groups. Results： All the cases were followed up. The accuracy of the screw placement, the average placement time of the single screw and the average fluoroscopic frequency of the single screw in the navigation group were significantly higher than those in the template group （ P 〈 0. 05 ）. Conclusion： Electric C - ann computer - assisted 3 D navigation system is the better choice to improve the accuracy of lumbar pedicle fixation, while the 3D printing single vertebral bilateral bridge type template has an advantage in the average placement time of the single screw and the average fluoroscopic frequency of the single screw. By contrast, navigation method has higher clinical value in the lumbar pedicle screw placement.