Department of Orthopedics, The Second Affiliated Hospital of Shanxi Medical University, No. 382 of 51 Road, Taiyuan, Shanxi, China.
Department of Orthpaedics, The Logistics Support Forces of Chinese PLA 985 Hospital, Taiyuan, Shanxi, China.
J Healthc Eng. 2022 Aug 31;2022:7907191. doi: 10.1155/2022/7907191. eCollection 2022.
To examine the effects of 3D printing model in total en bloc spondylectomy (TES).
We performed a retrospective chart review of 41 cases of spinal tumors at our institution between 2017 and 2020, in which TES was applied. There were 19 cases with 3D printing model and 22 cases without 3D printing model. Operation time, intraoperative blood loss, excision range, complications, VAS, and ASIA grades were recorded. Statistical methods were used to analyze the data. KaplanMeier survival curve was made to evaluate the survival.
There were significant differences in intraoperative blood loss between the two groups. The rate of R0 resection and tumor envelope preservation were higher in 3D group than that in non-3D group. In 3D group, the complications included surgical site infection (5.2%) and cerebrospinal fluid leak (15.7%). In non-3D group, the complications included cerebrospinal fluid leak (27.3%) and nerve root injury (13.6%). The pain and neurological dysfunction were significantly relieved before and after surgery in 3D group. However, the neurological relief in non-3D group patients was not complete. The VAS scores of non-3D group at 6 months after surgery were much higher than that of 3D group.
The application of 3D printing model not only helps surgeons observe the morphology, invasion range, and anatomic relationship of the tumor preoperatively, but also assists surgeons to judge, locate, and separate the tumor intraoperatively. For spinal malignancies, the 3D printing model is worth promoting.
探讨 3D 打印模型在全脊椎整块切除术(TES)中的应用效果。
回顾性分析 2017 年至 2020 年我院收治的 41 例脊柱肿瘤患者的临床资料,所有患者均行 TES 治疗,其中 19 例患者采用 3D 打印模型辅助手术(3D 组),22 例患者未采用 3D 打印模型(非 3D 组)。记录两组患者的手术时间、术中出血量、切除范围、并发症发生情况、视觉模拟评分(VAS)及美国脊髓损伤协会(ASIA)分级。采用统计学方法对数据进行分析,Kaplan-Meier 生存曲线评估患者的生存情况。
两组患者术中出血量比较,差异有统计学意义(P<0.05)。3D 组患者肿瘤整块切除率和包膜完整性保护率高于非 3D 组。3D 组患者术后并发症发生率为 5.2%(1/19),主要为手术部位感染;非 3D 组患者术后并发症发生率为 27.3%(6/22),主要为脑脊液漏和神经根损伤。3D 组患者术后疼痛和神经功能障碍均较术前明显缓解,而非 3D 组患者术后神经功能恢复不完全,术后 6 个月 VAS 评分高于 3D 组。
3D 打印模型的应用不仅有助于术者术前观察肿瘤的形态、侵袭范围和解剖关系,还能帮助术者术中判断、定位和分离肿瘤。对于脊柱恶性肿瘤,3D 打印模型具有一定的临床应用价值。