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3D打印经皮导板辅助经皮后凸成形术治疗骨质疏松椎体压缩性骨折
Hits: 984   Download times: 351   Received:April 14, 2022    
作者Author单位UnitE-Mail
廖江龙 LIAO Jiang-long 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
邓力 DENG Li 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
李德光 LI De-guang 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
孙皓民 SUN Hao-min 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
李鉴 LI Jian 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
苏燕 SU Yan 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
江波 JIANG Bo 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China  
李律宇 LI Lyu-yu 昆明市中医医院骨伤科, 云南 昆明 650000 Department of Orthopaedics, Kunming Hospital of Traditional Chinese Medicine, Kunming 650000, Yunnan, China lilvyu@qq.com 
期刊信息:《中国骨伤》2023年36卷,第5期,第445-449页
DOI:10.12200/j.issn.1003-0034.2023.05.010
基金项目:昆明市卫生健康委员会项目(编号:2020-10-01-111)


目的:验证3D打印经皮导板辅助经皮后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松椎体压缩性骨折(osteoporosis vertebral compression fractures,OVCFs)的安全性。

方法:对2020年11月至2021年8月,采用PKP治疗的60例OVCFs患者进行回顾性分析,男24例,女36例,年龄72~86(76.5±7.9)岁,其中30例采用常规PKP治疗(常规组),30例采用3D打印经皮导板辅助PKP治疗(导板组)。观察术中椎弓根穿刺时间(穿刺针到椎体后缘)及透视次数,手术总时间,总透视次数,骨水泥注入量,并发症(椎管型骨水泥渗漏),比较两组患者术前和术后3 d的视觉模拟评分(visual analogue scale,VAS)及伤椎前缘压缩率。

结果: 60例患者均成功实施手术,无椎管型骨水泥渗漏并发症发生。导板组椎弓根穿刺时间(10.23±3.15) min,透视次数(4.77±1.07)次,手术总时间(33.83±4.21) min,总透视次数为(12.27±2.61)次;常规组椎弓根穿刺时间(22.83±3.09) min,透视次数(10.93±1.62)次,手术总时间(44.33±3.57) min,总透视次数为(19.20±2.67)次;两组椎弓根穿刺时间及透视次数、手术总时间、总透视次数比较,差异有统计学意义(P<0.05);骨水泥注入量比较,差异无统计学意义(P>0.05)。术后3 d,两组VAS和伤椎前缘压缩率比较,差异无统计学意义(P>0.05)。

结论: 3D打印经皮导板辅助PKP术安全可靠,可减少透视次数,缩短手术时间,减少患者及医护人员射线暴露,符合骨科精准治疗的理念。
[关键词]:打印,三维  椎体后凸成形术  骨质疏松  脊柱骨折
 
Percutaneous kyphoplasty assisted by three dimensional printing percutaneous guide plate for the treatment of osteoporotic vertebral compression fractures
Abstract:

Objective To verify the safety of three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures(OVCFs).

Methods The clinical data of 60 patients with OVCFs treated by PKP from November 2020 to August 2021 were retrospectively analyzed. There were 24 males and 36 females,aged from 72 to 86 years old with an average of (76.5±7.9) years. Routine percutaneous kyphoplasty was performed in 30 cases (conventional group) and three dimensional printing percutaneous guide plate assisted PKP was performed in 30 cases (guide plate group). Intraoperative pedicle puncture time (puncture needle to posterior vertebral body edge) and number of fluoroscopy,total operation time,total number of fluoroscopy,amount of bone cement injection,and complication (spinal canal leakage of bone cement) were observed. The visual analogue scale (VAS) and the anterior edge compression rate of the injured vertebra were compared before operation and 3 days after operation between two groups.

Results All 60 patients were successfully operated without complication of spinal canal leakage of bone cement. In the guide plate group,the pedicle puncture time was(10.23±3.15) min and the number of fluoroscopy was(4.77±1.07) times,the total operation time was (33.83±4.21) min,the total number of fluoroscopy was(12.27±2.61) times;and in the conventional group,the pedicle puncture time was (22.83±3.09) min and the number of fluoroscopy was (10.93±1.62) times,the total operation time was(44.33±3.57) min,the total number of fluoroscopy was(19.20±2.67) times. There were statistically significant differences in the pedicle puncture time,intraoperative number of fluoroscopy,the total operation time,and the total number of fluoroscopy between the two groups(P<0.05). There was no significant difference in amount of bone cement injection between the two groups(P>0.05). There were no significant differences in VAS and the anterior edge compression rate of the injured vertebra at 3 days after operation between two groups(P>0.05).

Conclusion Three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty is safe and reliable,which can reduce the number of fluoroscopy,shorten the operation time,and decrease the radiation exposure of patients and medical staff,and conforms to the concept of precise orthopaedic management
KEYWORDS:Printing,three-dimensional  Kyphoplasty  Osteoporosis  Spinal fracture
 
引用本文,请按以下格式著录参考文献:
中文格式:廖江龙,邓力,李德光,孙皓民,李鉴,苏燕,江波,李律宇.3D打印经皮导板辅助经皮后凸成形术治疗骨质疏松椎体压缩性骨折[J].中国骨伤,2023,36(5):445~449
英文格式:LIAO Jiang-long,DENG Li,LI De-guang,SUN Hao-min,LI Jian,SU Yan,JIANG Bo,LI Lyu-yu.Percutaneous kyphoplasty assisted by three dimensional printing percutaneous guide plate for the treatment of osteoporotic vertebral compression fractures[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(5):445~449
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