3D打印技术在脊柱内窥镜治疗老年腰椎管狭窄症中的应用价值

Applicable value of 3D printing technology in endoscopic spinal surgery for the treatment of lumbar spinal stenosis in the elderly

目的探讨3D打印技术在脊柱内窥镜治疗老年腰椎管狭窄症中的应用价值。方法将2018年1月至2019年1月东莞市大朗医院收治的32例老年腰椎管狭窄症患者纳入研究,采用随机数字表法将患者随机分为3D打印组和对照组,每组16例,对照组采用脊柱内窥镜治疗,3D打印组应用3D打印技术结合脊柱内窥镜治疗,比较两组患者的疗效指标及并发症发生情况。结果随访时间6~12个月,平均随访时间8.4个月。3D打印组术中透视次数、手术时间均优于对照组,两组术后1周及末次随访时腰痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)均较术前有所改善,术后各时相点3D打印组腰痛VAS评分优于对照组(P<0.05),两组间歇性跛行改善优良率均为14/16。对照组1例术中有颈项部酸胀感,1例出现穿刺部位感染。结论3D打印技术结合脊柱内窥镜治疗老年腰椎管狭窄症有助于缩短手术时间,缓解术后腰痛,技术难度小,疗效良好,值得推广应用。

Objective To explore the value of 3 D printing technology in endoscopic spinal surgery for the treatment of elderly patients with lumbar spinal stenosis.Methods A total of 32 elderly patients with lumbar spinal stenosis who admitted in Dalang Hospital of Dongguan from January 2018 to January 2019 were included.They were randomly divided into two groups with 16 patients in each group.Patients in 3 D printing group were treated with 3 D printing technology combined with endoscopic spinal surgery,and patients in control group were treated with endoscopic spinal surgery only.Clinical efficacy-related indicators and complications were compared between two groups.Results All patients were followed up from 6 to 12 months,with the average time of 8.4 months.The fluoroscopy times and operation duration in 3 D printing group were superior to those in control group.The back pain visual analogue scale(VAS)score and Oswestry disability index(ODI)at 1 week postoperatively and at the latest follow-up in two groups were all improved compared with those preoperatively,and postoperative VAS scores of back pain in 3 D printing group were better than those in control group(P<0.05).The improvement rate of intermittent claudication in both groups was 14/16.In control group,1 patient had neck sensation of distension during the operation,and 1 patient suffered from infection at the puncture site.Conclusion Application of 3 D printing technology during endoscopic spinal surgery in the treatment of elderly patients with lumbar spinal stenosis is worth promoting and applying due to its shorter operation time,less postoperative back pain with relative low technical difficulty and good clinical effects.