数字化设计结合3D打印技术在脊柱压缩性骨折手术治疗中的应用

Application of digital design combined with 3D printing technology in surgical treatment of spinal compression fractures

目的数字化设计结合3D打印技术在脊柱压缩性骨折椎体成形术中的应用价值。方法根据随机对照分组原则,将2018年1月~2019年11月于我院骨科住院治疗的80例椎体压缩性骨折患者分为观察组(40例)和对照组(40例)。对照组运用常规椎体成形术治疗,而观察组在上述治疗基础上,于术前构建与打印伤椎3D模型,并依据该模型规划和模拟手术流程。分别评估两组患者术前、术后3d、术后3个月的视觉模拟评分法(VAS)评分、功能障碍指数(ODI)评分,并比较两组患者的透视次数、手术时间、骨水泥渗漏情况。结果观察组患者的手术时间短于对照组,透视次数少于对照组,骨水泥渗漏发生率低于对照组,差异均有统计学意义(P <0.05);但两组患者的神经根损伤发生率比较,差异无统计学意义(P> 0.05)。观察组患者术前、术后3d及3个月的ODI评分、VAS评分与对照组比较,差异无统计学意义(P> 0.05)。结论数字化设计结合3D打印技术辅助椎体成形术虽不能提高临床疗效,但其可以明显缩短手术时间、减少术中透视次数和骨水泥渗漏发生率,值得在基层医院推广应用。

Objective To explore the application value of digital design combined with 3 D printing technology in vertebroplasty for spinal compression fractures. Methods According to the principle of randomized controlled grouping, 80 patients with vertebral compression fractures who were hospitalized in our hospital from January 2018 to November 2019 were divided into observation group(40 cases) and control group(40 cases). The control group was treated with routine vertebroplasty, while the observation group on the basis of the control group, the 3 D model of injured vertebrae was constructed and printed before operation, and the operation process was planned and simulated according to the model. The visual analogue scale(VAS) scores and dysfunction index(ODI) scores were evaluated before operation, 3 days and 3 months after operation. The number of fluoroscopy, operation time and bone cement leakage were compared between the two groups. Results The operation time of the observation group was shorter than that of the control group, the number of fluoroscopy was less than that of the control group, and the bone cement leakage rate was lower than that in the control group, the differences were statistically significant(P < 0.05). However, there was no significant difference in the incidence of nerve root injury between the two groups(P > 0.05). There were no significant differences in ODI score and VAS score between the observation group and the control group before operation, 3 days and 3 months after operation(P > 0.05). Conclusion Digital design combined with 3 D printing technology assisted vertebroplasty cannot improve the clinical efficacy, but it can significantly shorten the operation time, reduce the number of intraoperative fluoroscopy and the leakage rate of bone cement, which is worthy of promotion and application in primary hospitals.