| 郑吉波,张红侠,刘立峰,张 宁,吴耀国,韩 康.3D打印技术在颈椎后路寰枢椎椎弓根置钉中的对比分析研究[J].,2019,19(16):3085-3088 |
| 3D打印技术在颈椎后路寰枢椎椎弓根置钉中的对比分析研究 |
| Clinical Application of a Novel 3D Printed Drill Guide Template in Atlantoaxial Pedicle Screw Placement |
| 投稿时间：2019-03-06 修订日期：2019-03-30 |
| DOI：10.13241/j.cnki.pmb.2019.16.015 |
| 中文关键词: 导板 椎弓根螺钉 3D打印 |
| 英文关键词: Drill guide template Pedicle screw 3D printing |
| 基金项目:国家自然科学基金项目(81702935)；济南军区总医院院长基金项目(2015ZX01) |
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| 中文摘要: |
| 摘要 目的：探讨和比较通过3D打印技术制作的标杆型导板在颈椎后路手术寰枢椎椎弓根置钉中的优势和安全性。方法：回顾性分析我院我科自2016.09至2018.09因颈椎病入院并行颈后路手术且行寰枢椎椎弓根置钉的共计58例。按照是否使用3D打印技术制作的标杆性导板而将其分为实验组及对照组。实验组（28例）在导板辅助下进行置钉，而对照组（30例）则采用常规的徒手置钉。比较两组患者的置钉手术时间，透视次数，出血量，置钉的准确性，两组患者的术后及术后半年的疼痛评分（VAS）及日本骨科协会颈椎功能评分（JOA）评分。结果：所有患者均随访半年以上。两组患者在出血量指标的比较中未发现统计学差异(P>0.05)。实验组的透视次数及手术时间均显著少于对照组，其准确度在显著优于对照组(P<0.05)。两组患者在疼痛评分及功能评分的比较中均未发现显著性差异(P>0.05)。结论：与传统常规手术技术相比，使用3D打印技术标杆性导板能有效的降低透视次数和手术时间，提高置钉的准确性，且不增加风险，具有很好的安全性。在临床中可进一步的进行推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the reliability of using the template with guide rods for atlantoaxial pedicle screw placement, and to compare the clinical outcomes of atlantoaxial pedicle screw placement by using the novel 3D printed template and by the conventional method. Methods: From 2017.09 to 2018.09，58 patients diagnosed as cervical spondylotic disease were retrospectively analyzed. All the patients were divided into two groups by different surgery types. 28 patients underwent surgery using a novel 3D printed drill guide template(experimental group), while 30 patients underwent surgery by conventional method (control group). The clinical outcomes were evaluated by operation time, intraoperative blood loss, frequency of fluoroscopy in surgery, screw placement accuracy. Japanese Orthopaedic Association (JOA) score of cervical neurological function, and visual analogue scal (VAS) of pain were used for comparisons between the two groups. Results: All the patients underwent successful 6 months completed follow-up. The experimental group had similar results in blood loss, pre-and postoperative JOA scores and VAS scores, and improvement rate of JOA score with those in control group(P>0.05). The intraoperative fluoroscopy frequency and operation time was significantly lower in the experimental group(P< 0.05), and the screw placement accuracy was significantly higher in the experimental group than those in control group (P< 0.05). Conclusion: Comparing the conventional method, using the novel drill guide template can result in lower intraoperative fluoroscopy frequency and higher screw placement accuracy without increasing the risk, which could be further promoted in clinic. |
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