3D打印人工椎体治疗颈椎后纵韧带骨化症疗效分析

Clinical Efficacy Analysis of 3D Printed Artificial Vertebrae in the Treatment of Cervical Posterior Longitudinal Ligament Ossification

目的探讨3D打印人工椎体治疗颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的临床疗效.方法回顾性分析19例OPLL患者临床资料,患者均采用颈前路椎体次全切除减压融合术(anterior cervical corpectomy and fusion,ACCF)、3D打印人工椎体植入及钛板内固定术,比较术前、术后1周、术后3个月和术后12个月随访时JOA评分(日本骨科协会评分,Japanese orthopaedic association)、VAS评分(视觉模拟评分法,Via analogue scale)及颈椎Cobb角.结果19例患者均得到随访,术后1周、术后3个月及术后12个月随访时的VAS评分、JOA评分及颈椎Cobb角与术前比较均得到明显改善(P<0.001).末次随访时均骨性融合,无内植物松动断裂发生.结论使用3D打印人工椎体治疗颈椎后纵韧带骨化症能充分减压脊髓并重建颈椎的稳定性,能获得满意的临床疗效.

Objective To investigate the clinical efficacy of 3D printed artificial vertebral body in the treatment of ossification of posterior longitudinal ligament(ossification of posterior longitudinal ligament,OPLL)of the cervical spine.Method Collect clinical data of patients with ossification of the posterior longitudinal ligament of the cervical spine and conduct a retrospective analysis.19 patients underwent anterior cervical corpectomy and fusion(ACCF),3D printed artificial vertebral body implantation and titanium plate internal fixation.Preoperative,postoperative 1 week,postoperative 3 months and postoperative 12 months follow-up were performed to compare the Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)score and Cobb angle of cervical spine.Results All 19 patients were followed up,and the VAS scores,JOA scores and Cobb angle of cervical spine at postoperative 1 week,postoperative 3 months and postoperative 12 months follow-up were significantly improved comparing with those before surgery,and the differences were statistically significant(P<0.001).All patients were bone healing at the last follow-up,and no fracture or malposition of implants were seen in all patients.Conclusion Treatment of ossification of posterior longitudinal ligament using 3D printed artificial vertebral body can fully decompress the spinal cord and reconstruct the stability of the cervical spine,achieve satisfactory clinical efficacy.