个体化3D打印辅助后路螺钉内固定治疗上颈椎损伤的效果及并发症分析

Effect and complications of individualized 3D printing-assisted posterior screw internal fixation in the treatment of upper cervical injury

目的 探讨个体化3D打印辅助后路螺钉内固定治疗上颈椎损伤的效果及并发症。方法 选取2018年2月~2021年12月在本院行颈椎后路内固定手术治疗的上颈椎损伤患者40例,根据不同手术方式分为3D打印组(20例,行个体化3D打印辅助后路螺钉内固定治疗)和徒手置钉组(20例,行徒手法置钉颈椎后路内固定治疗)。比较两组患者手术相关指标及术后疗效。结果 3D打印组手术时间短于徒手置钉组,术中出血量、术后引流量均少于徒手置钉组(P<0.05);两组术后VAS评分均显著降低(P<0.05),但组间差异无统计学意义(P>0.05);3D打印组术后置钉情况优于徒手置钉组(P<0.05),术后3个月骨融合情况优于徒手置钉组(P<0.05);术后6个月两组患者Frankel分级均有所改善,且3D打印组改善效果较好(P<0.05)。结论 个体化3D打印辅助后路螺钉内固定治疗上颈椎损伤的临床疗效显著,能有效缩短手术时间,减少术中出血量,提高置钉准确性,促进骨融合,减少医源性并发症。

Objective To explore the effect and complications of individualized 3D printing-assisted posterior screw internal fixation in the treatment of upper cervical injury. Methods A total of 40 patients with upper cervical injury undergoing cervical posterior internal fixation in the hospital were enrolled between February 2018 and December 2021. According to different surgical methods, they were divided into 3D printing group(20 cases, individualized 3D printing-assisted posterior screw internal fixation) and manual screw fixation group(20 cases, manual screw internal fixation). The operation related indicators and postoperative effects were compared between the two groups. Results The operation time in 3D printing group was shorter than that in manual screw fixation group, the intraoperative blood loss and postoperative drainage volume were fewer than those in manual screw fixation group(P<0.05). After surgery, VAS scores were decreased in both two groups(P<0.05), there was no significant difference between the two groups(P>0.05). The postoperative screw fixation in 3D printing group was better than that in manual screw fixation group, and bone fusion was better than that in manual screw fixation group at 3 months after surgery(P<0.05). After surgery, the Frankel grades were improved in both two groups, and the Frankel grades of the 3D printing group was better at 6 months after surgery(P<0.05). Conclusion Clinical curative effect of individualized 3D printing-assisted posterior screw internal fixation is significant on upper cervical injury, which can effectively shorten operation time, reduce intraoperative blood loss, improve accuracy of screw fixation, promote bone fusion and reduce iatrogenic complications.