Huang Kangkang, Pan Xuelin, Wen Yuting, Wang Beiyu, Ding Chen, Wu Tingkui, Rong Xin, Liu Hao
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2023 Jan 9;9:1084804. doi: 10.3389/fsurg.2022.1084804. eCollection 2022.
The choice of trough position in Expansive open-door laminoplasty (EOLP) mostly relied on bony landmarks and surgeons' experience. The present study was to validate the efficacy of the three-dimensional (3D) printed patient-specific drilling templates with the function of locating and depth control for EOLP.
A single-center, prospective randomized controlled study was conducted on the patients who underwent unilateral EOLP from August 2019 to December 2020. The 3D printed patient-specific drilling template was fabricated and used in the template group. All the EOLP were performed by a senior surgeon and a junior surgeon. The clinical outcomes and radiographic results were evaluated.
A total of 37 patients who completed the 12-month follow-up were analyzed. The clinical outcomes were significantly improved after surgery in both groups ( < 0.05). The visual analogue scale (VAS) scores were significantly lower in the template group at 12 months postoperatively ( < 0.05). The anteroposterior diameter, Pavlov's ratio and Open angle were all higher in the template group than those in the control group at 3 days and 12 months postoperatively ( < 0.05). The satisfaction of the trough position on both sides and incomplete fracture rate on the hinge side were higher in the template group based on the CT scans taken 3 days after surgery ( < 0.05). To the junior surgeon, the satisfaction and the incomplete fracture rate were significantly higher in the template group compared with those in the control group ( < 0.05).
The application of 3D printed patient-specific drilling templates with the function of locating and depth control for EOLP could improve the outcome of neck pain relief and expand the decompression. It can also improve the satisfaction of the trough position on the open-door side and the hinge side and decrease the complete fracture rate on the hinge side, especially for the junior surgeon.
扩大开门椎板成形术（EOLP）中槽沟位置的选择大多依赖于骨性标志和术者经验。本研究旨在验证具有定位和深度控制功能的三维（3D）打印个体化钻孔模板在EOLP中的有效性。
对2019年8月至2020年12月接受单侧EOLP的患者进行单中心、前瞻性随机对照研究。制作3D打印个体化钻孔模板并应用于模板组。所有EOLP手术均由一名资深外科医生和一名初级外科医生完成。评估临床疗效和影像学结果。
共分析了37例完成12个月随访的患者。两组术后临床疗效均显著改善（<0.05）。模板组术后12个月视觉模拟评分（VAS）显著更低（<0.05）。术后3天和12个月时，模板组的矢状径、Pavlov比值和开门角度均高于对照组（<0.05）。根据术后3天的CT扫描结果，模板组双侧槽沟位置满意度及铰链侧不完全骨折率更高（<0.05）。对于初级外科医生而言，模板组的满意度和不完全骨折率显著高于对照组（<0.05）。
具有定位和深度控制功能的3D打印个体化钻孔模板应用于EOLP可改善颈部疼痛缓解效果并扩大减压范围。还可提高开门侧和铰链侧槽沟位置的满意度，降低铰链侧完全骨折率，尤其对于初级外科医生。
