3D打印辅助经后路椎弓根钉棒内固定治疗强直性脊柱炎并胸腰椎骨折的效果

3D Printing Assisted Posterior Pedicle Screw Fixation for the Treatment of Ankylosing Spondylitis and Thoracolumbar Fractures

目的分析3D打印辅助经后路椎弓根钉棒内固定治疗强直性脊柱炎并胸腰椎骨折的效果。方法选取2018年12月至2020年12月郑州市骨科医院收治的91例强直性脊柱炎并胸腰椎骨折患者。患者均接受经后路椎弓根钉棒内固定治疗。根据辅助检查方式将患者分为对照组(45例)和观察组(46例)。给予对照组患者常规X线辅助。给予观察组患者3D打印辅助手术。比较两组手术时间、术中失血量、术后引流量、置钉准确率。分别于术前、术后3个月采用日本骨科协会(JOA)评估量表评估脊柱功能,采用Oswestry功能障碍指数评估腰椎功能。结果观察组手术时间较对照组短,术中失血量、术后引流量较对照组少(P<0.05)。观察组置钉准确率较对照组高(P<0.05)。术后3个月,两组JOA评分较术前高,Oswestry评分较术前低(P<0.05);术后3个月,观察组JOA评分较对照组高,Oswestry评分较对照组低(P<0.05)。结论3D打印辅助经后路椎弓根钉棒内固定治疗强直性脊柱炎并胸腰椎骨折患者,可缩短手术时间,降低手术创伤性,提高置钉准确率,促进脊柱和腰椎功能恢复。

Objective To analyze the effect of 3D printing assisted posterior pedicle screw fixation in the treatment of ankylosing spondylitis and thoracolumbar fractures.Methods A total of 91 patients with ankylosing spondylitis and thoracolumbar fractures admitted to Zhengzhou Orthopedic Hospital from December 2018 to December 2020 were selected.All patients were treated with posterior pedicle screw fixation.According to the auxiliary examination method,the patients were divided into control group(45 cases)and observation group(46 cases).The patients in control group were given routine X-ray assistance.3D printing assisted surgery was given to the patients in observation group.The operation time,intraoperative blood loss,postoperative drainage volume and nail placement accuracy were compared between the two groups.Japanese Orthopedic Association(JOA)assessment scale was used to assess spinal function before and 3 months after surgery,and the Oswestry dysfunction index was used to assess lumbar function.Results The operation time in observation group was shorter than that in control group,and the blood loss and postoperative drainage were less than those in control group(P<0.05).The nail placement accuracy rate in observation group was higher than that in control group(P<0.05).At 3 months after operation,the scores of JOA in the two groups were higher than those before operation,and the scores of Oswestry in the two groups were lower than those before operation(P<0.05).At 3 months after operation,the score of JOA in observation group was higher than that in control group,and the score of Oswestry in observation group was lower than that in control group(P<0.05).Conclusion 3D printing assisted posterior pedicle screw fixation for patients with ankylosing spondylitis and thoracolumbar fractures could shorten the operation time,reduce surgical trauma,improve the accuracy of nail placement,and promote the recovery of spine and lumbar spine function.