Pan Aixing, Ding Hongtao, Hai Yong, Liu Yuzeng, Hai Junrui Jonathan, Yin Peng, Han Bo
Department of Orthopedic Surgery, 74639Beijing Chao-Yang Hospital, Capital Medical University, Chaoyang District, Beijing, China.
261768The High School Affiliated to Renmin University of China, Haidian District, Beijing, China.
Global Spine J. 2023 Apr;13(3):787-795. doi: 10.1177/21925682211008830. Epub 2021 May 11.
Retrospective case-control study.
We aimed to evaluate the value of 3-dimensional printing (3DP) spine model in the surgical treatment of severe spinal deformity since the prosperous development of 3DP technology.
Severe scoliosis or hyper-kyphosis patients underwent posterior fixation and fusion surgery using the 3DP spine models were reviewed (3DP group). Spinal deformity surgeries operated by free-hand screw implantation during the same period were selected as the control group after propensity score matching (PSM). The correction rate, pedicle screw accuracy, and complications were analyzed. Class A and B screws were defined as accurate according to Gertzbein and Robbins criteria.
35 patients were enrolled in the 3DP group and 35 matched cases were included in the control group. The perioperative baseline data and deformity correction rate were similar between both groups ( > .05). However, the operation time and blood loss were significantly less in the 3DP group (296.14 ± 66.18 min vs. 329.43 ± 67.16 min, 711.43 ± 552.28 mL vs. 1322.29 ± 828.23 mL, < .05). More three-column osteotomies (Grade 3-6) were performed in the 3DP group (30/35, 85.7% vs. 21/35, 60.0%. = .016). The screw placement accuracy was significantly higher in the 3DP group (422/582, 72.51% vs. 397/575, 69.04%. = .024). The screw misplacement related complication rate was significantly higher in the free-hand group (6/35 vs. 1/35, = .046).
The study provided solid evidence that 3DP spine models can enhance surgeons' confidence in performing higher grade osteotomies and improve the safety and efficiency in severe spine deformity correction surgery. 3D printing technology has a good prospect in spinal deformity surgery.
回顾性病例对照研究。
自三维打印（3DP）技术蓬勃发展以来，我们旨在评估3DP脊柱模型在严重脊柱畸形手术治疗中的价值。
对使用3DP脊柱模型接受后路固定融合手术的严重脊柱侧弯或后凸畸形患者进行回顾性研究（3DP组）。在倾向得分匹配（PSM）后，选择同期徒手置入螺钉进行的脊柱畸形手术作为对照组。分析矫正率、椎弓根螺钉置入准确性及并发症情况。根据Gertzbein和Robbins标准，A类和B类螺钉定义为置入准确。
3DP组纳入35例患者，对照组纳入35例匹配病例。两组围手术期基线数据及畸形矫正率相似（P>0.05）。然而，3DP组手术时间和失血量显著更少（296.14±66.18分钟对329.43±67.16分钟，711.43±552.28毫升对1322.29±828.23毫升，P<0.05）。3DP组进行更多的三柱截骨术（3-6级）（30/35，85.7%对21/35，60.0%，P=0.016）。3DP组螺钉置入准确性显著更高（422/582，72.51%对397/575，69.04%，P=0.024）。徒手组螺钉误置相关并发症发生率显著更高（6/35对1/35，P=0.046）。
该研究提供了确凿证据，表明3DP脊柱模型可增强外科医生进行更高等级截骨术的信心，并提高严重脊柱畸形矫正手术的安全性和效率。3D打印技术在脊柱畸形手术中有良好前景。
