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中国现代手术学杂志  2017, Vol. 21 Issue (5): 321-326    DOI: 10.16260/j.cnki.1009-2188.2017.05.001
  手术学研究 |
3D打印技术在经皮椎体成形术中的临床应用
王欣文,刘继军,王文涛,吴起宁,郝定均,屈巍
西安交通大学医学部附属红会医院脊柱外科,西安 710054
Clinical Application of ThreeDimensional Printing Technology in Percutaneous Vertebroplasty
WANG Xin-wen, LIU Ji-jun, WANG Wen-tao, WU Qi-ning,HAO Ding-jun, QU Wei
Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054,Shaanxi, China
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摘要 目的探讨3D打印技术在经皮椎体成形术治疗中的可行性和临床应用价值。方法2014年2月至2015年2月共纳入64例患者行经皮椎体成形手术治疗,术前常规行X线片、CT三维重建及MRI检查。随机分成两组,对照组32例采取常规穿刺的方法,注入骨水泥;实验组32例应用3D打印技术,制作出伤椎的三维模型,明确椎体的病变部位,精准地进行经皮椎体成形术。结果64 例均获得随访,末次随访时间为术后12个月。实验组X射线暴露次数、手术时间显著低于对照组,两组间差异具有统计学意义(P<0.05)。实验组后凸Cobb角改善与对照组相比,差异无统计学意义(P>0.05);实验组30例骨水泥无或轻微渗漏,2例较明显,对照组26例骨水泥无或轻微渗漏,6例渗漏较明显,两组间差异具有统计学意义(P<0.05)。末次随访时,两组患者VAS评分、ODI评分较术前明显改善,差异具有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05)。结论采用3D打印技术,可明确穿刺部位,及时调整穿刺路径,从而高效精准地完成经皮椎体成形术。
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WANG Xin-wen
LIU Ji-jun
WANG Wen-tao
WU Qi-ning
HAO Ding-jun
QU Wei
关键词:  3D打印  胸腰椎骨折  经皮椎体成形术  骨质疏松    
Abstract: ObjectiveTo explore the feasibility and clinical value of threedimensional (3D) printing technology in percutaneous vertebroplasty.MethodsFrom February 2014 to February 2015,a total of 64 patients were selected for percutaneous vertebroplasty. The patients received Xray, CT threedimensional reconstruction and MRI preoperatively. They were divided into two groups randomly, with 32 cases in each. The control group was punctured and injected bone cement by the conventional method. And the experimental group was punctured under the guidance of the demonstration of the vertebral lesions through the 3D model of the injured vertebral, and then an accurate PVP was performed.ResultsSixty four patients got followed up for 12 months. Xray exposure time and operation time of the experimental group was significantly shorter than the control group (P<0.05). There was no significant difference in the improved kyphotic Cobb angle between the two groups (P>0.05). Cement leakage occurred in 2 of the 32 patients in the experimental group, while six cases of bone cement leakage was observed in the control group, and the difference was significant(P<0.05). There were significant differences in the VAS score and ODI score between the preoperative one and the postoperative one in both two groups (P<0.05), and there was no significant difference between the two groups at the end of followup (P>0.05).ConclusionIt plays an important role of the 3D printing technology in guiding the percutaneous vertebraplasty puncture, which can improve the accuracy of the PVP in the future.
Key words:  threedimensional printing technology    thoracolumbar fractures    percutaneous kyphoplasty    osteoporosis
收稿日期:  2017-03-25      修回日期:  2017-10-09           出版日期:  2017-10-26      发布日期:  2018-05-15      期的出版日期:  2017-10-26
ZTFLH:  R683.2  
基金资助: 陕西省社发攻关项目 (2017SF-233)
通讯作者:  屈巍,男,33岁,西安交通大学医学部附属红会医院脊柱外科主治医师。   
作者简介:  王欣文,男,34岁,西安交通大学医学部附属红会医院脊柱外科主治医师。
引用本文:    
王欣文,刘继军,王文涛,吴起宁,郝定均,屈巍. 3D打印技术在经皮椎体成形术中的临床应用[J]. 中国现代手术学杂志, 2017, 21(5): 321-326.
WANG Xin-wen, LIU Ji-jun, WANG Wen-tao, WU Qi-ning,HAO Ding-jun, QU Wei. Clinical Application of ThreeDimensional Printing Technology in Percutaneous Vertebroplasty. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 321-326.
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