3D打印手术导板辅助强直性脊柱炎截骨矫形

3D printed guiders assisted osteotomy and instrumented fusion for correction of kyphosis secondary to ankylosing spondylitis

[目的]介绍3D打印手术导板辅助强直性脊柱炎截骨矫形的手术技术和初步临床结果。[方法]选取本院16例强直性脊柱炎患者,男11例,女5例;年龄19~42岁,平均(28.00±6.59)岁。术前CT扫描并三维重建脊柱模型。根据术前规划选择L1、L3双节段截骨并确定截骨角度。术前设计对应的手术导板,3D打印实体导板并消毒,术中辅助手术截骨矫形。[结果] 16例患者均顺利完成手术,手术时间(256.25±35.38) min,出血量(2 096.88±350.94) ml,住院时间(10.44±2.10) d。术后随访时间12~36个月,除1例发生邻近椎体压缩骨折经保守治愈外,余无特殊。患者矫形维持良好,截骨面均愈合,生活质量显著改善。[结论] 3D打印手术导板辅助强直性脊柱炎截骨矫形是一种安全可行且精确性较高的手术方法。

[Objective] To introduce the surgical technique and primary clinical results of 3 D printed guiders assisted osteotomy and instrumented fusion for correction of kyphosis secondary to ankylosing spondylitis. [Methods] Sixteen patients, 11 males and 5 females aged(28.00±6.59) years on average, underwent the aforesaid surgical procedures for correction of kyphosis subsequent to ankylosing spondylitis in our hospital. Before operation, thoracolumbar CT scanning was conducted, and three-dimensional reconstruction of the spine model was made individually in all the patients. Double segment osteotomies at L1 and L3 respectively were planned and mimicked on the spinal models, and corresponding guiders for osteotomy and pedicle screw placement were designed and made by 3 D printer. After that, the real surgical operation was finished with the corresponding 3 D printed guiders for osteotomies and pedicle screw placement. [Results] The operation lasted for(256.25±35.38) min on average,with blood loss of(2 096.88±350.94) ml, and the hospital stay of(10.44±2.10) d. The postoperative follow-up period lasted for12~36 months. Except one patient who suffered from adjacent vertebral compression fracture that cured following conservative treatment, all patients got satisfactory maintenance of deformity correction at the latest follow up, with bony fusion of the involved segments and significant improvement of life quality. [Conclusion] The 3 D printed guiders assisted osteotomy and instrumented fusion are safe, feasible and accurate surgical procedures for correction of kyphosis secondary to ankylosing spondylitis.