3D打印技术在颈椎手术术前谈话及手术中的应用

Application of 3D Printing Technology in Preoperative Conversation and Operation of Cervical Spine

目的:介绍3D打印技术在颈椎手术术前谈话中的应用,评价其在手术中的应用价值。方法:回顾性收集47例颈椎手术患者的临床资料,3D组23例采用3D打印1∶1病变部位实物模型辅助,常规组24例采用常规影像学资料辅助,完成术前谈话及手术。仿照VAS评分法评估两组在术前谈话时患者及家属对病情及手术的理解程度和沟通满意程度。记录两组术前谈话时间、病情及手术理解程度、沟通满意程度,手术时间、术中出血量、并发症例数,术前与术后颈肩部疼痛VAS评分和颈椎神经功能JOA评分。结果:两组术中均无神经血管损伤等并发症出现。3D组与常规组术前谈话时间[(12.1±2.7)min vs(16.3±3.5)min]、沟通满意程度[(9.3±0.5)分vs (8.9±0.6)分]、手术时间[(136.5±24.4)min vs(152.9±27.3)min]、术中出血量[(148.3±29.1)mL vs(201.5±33.6)mL]差异均有统计学意义(P<0.05)。3D组与常规组病情及手术理解程度比较,差异无统计学意义(P>0.05)。3D组术后术前VAS评分[(2.5±0.9)分vs (7.8±1.3)分]、JOA评分[(13.5±1.2)分vs(8.4±1.7)分]比较差异有统计学意义(P<0.05);常规组术后术前VAS评分[(2.2±0.8)分vs(7.6±1.2)分]、JOA评分[(13.4±1.5)分vs(8.3±1.8)分]比较差异有统计学意义(P<0.05);而组间比较差异均无统计学意义(P>0.05)。结论:应用3D打印技术辅助颈椎手术术前谈话及手术,在达到与常规方法相似的理解程度下,不仅具有用时少,沟通满意度高的优点,而且缩短手术时间、减少术中出血量,临床疗效满意。

Objective To introduce the application of 3D printing technology in the preoperative conversation of cervical spine surgery and to evaluate its application value in the operation. Methods The clinical data of 47 patients with cervical spine surgery were retrospectively collected. Twenty-three cases in 3 D group were assisted with 1 ： 1 cervical models of 3 D printing technology, while 24 cases in the routine group were assisted with conventional imaging data, to complete the preoperative conversation and surgery. The imitated VAS assessment method was used to evaluate the understanding degree of condition and operation and the satisfaction degree of preoperative communication in patients and their family. The time of preoperative conversation, understanding degree of condition and operation, satisfaction degree of preoperative communication, operation time, intraoperative blood loss, number of complications, preoperative and postoperative cervical spine visual analogue scores （VAS） and spinal function scores of Japanese Orthopedic Association （JOA） in the two groups were recorded. Results There were no complications such as neurovasculax injury in the two groups. There were significant differences in the time of preoperative conversation [（12.1 ± 2.7） min vs （16.3 ± 3.5） min], the satisfaction degree of preoperative communication [（9.3 ± 0.5） scores vs. （8.9 ± 0.6） scores], operation time [（136.5 ± 24.4） min vs （152.9 ± 27.3） mini and intraoperative blood loss [（148.3 ± 29.1） mL vs （201.5 ± 33,6） mL] of 3 D group and routine group （P〈0.05）. There was no significant difference in the understanding degree of condition and operation of 3 D group and routine group.（P〉0.05）. There were significant differences between the postoperative and preoperative VAS scores [（2.5 ± 0.9） scores vs （7.8 ± 1.3） scores], JOA scores [（13.5 ± 1.2） scores vs （8.4 ± 1.7） scores] in the 3D group（P〈0.05）.There were significant differences between the postoperative and preoperative VAS scores [（2.2 ± 0.8） scores vs （7.6 ± 1.2） scores], JOA scores [（13.4 ± 1.5） scores vs （8.3 ± 1.8） scores] in the routine group respectively （P〈0.05）. While there were no significant differences between the two groups respectively （P〉0.05）. Conclusion The application of 3D printing technology to assist preoperative communication and operation of cervical spine surgery not only has the advantages of less time-consuming, higher communication satisfaction degree, but also could short the operation time and reduce intraoperative blood loss, with satisfied clinical efficacy.