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3D打印人工椎体与钛网笼在单节段颈椎前路椎体次全切除融合术中的影像学和临床结果比较:一项荟萃分析

Comparison of radiological and clinical outcomes of 3D-printed artificial vertebral body with Titanium mesh cage in single-level anterior cervical corpectomy and fusion: A meta-analysis.

作者信息

Cheng Haiyang, Luo Gan, Xu Dan, Li Yuqiao, Wang Ziqi, Yang Houzhi, Liu Yang, Jia Yutao, Sun Tianwei

机构信息

Graduate School of Tianjin Medical University, Tianjin, China.

Department of Spinal Surgery, Tianjin Union Medical Center, Tianjin, China.

出版信息

Front Surg. 2023 Jan 11;9:1077551. doi: 10.3389/fsurg.2022.1077551. eCollection 2022.

Abstract

PROPOSE

This meta-analysis aimed to determine whether 3D-printed artificial vertebral body have superior clinical and radiographic outcome than Titanium Mesh Cage(TMC) in single-level anterior cervical corpectomy and fusion.

METHODS

A comprehensive search of the PubMed, Embase, Cochrane Library, Web of Science, and CNKI (China National Knowledge Infrastructure) databases was conducted to find randomized control trials (RCTs) or cohort studies that compared 3D-printed artificial vertebral body with conventional Titanium Mesh Cage (TMC) in single-level anterior cervical corpectomy and fusion (SL-ACCF). Operation time; intraoperative blood loss; subsidence of vertebral body; preoperative, and final follow-up C2-C7 Cobb angle, Japanese Orthopedic Association (JOA) scores, and Visual Analog Scale(VAS) scores were collected from eligible studies for meta-analysis.

RESULTS

We included 6 cohort studies with 341 patients. The results of the meta-analysis showed that the 3D group has a shorter operation time than the traditional TMC group( = 0.04) and the TMC group had more severe subsidence(≥3 mm) of vertebral body than the 3D group( < 0.0001). And the cervical C2-C7 Cobb angle in the 3D group was larger than that in the TMC group at the final follow-up.

CONCLUSION

This meta-analysis demonstrates that 3D-printed artificial vertebral body is superior to traditional TMC in reducing the operation time and maintaining the postoperative vertebral height and restoring sagittal balance to the cervical spine in single-level anterior cervical corpectomy and fusion.

摘要

目的

本荟萃分析旨在确定在单节段颈椎前路椎体切除融合术中,3D打印人工椎体在临床和影像学结果方面是否优于钛网笼(TMC)。

方法

全面检索了PubMed、Embase、Cochrane图书馆、Web of Science和中国知网(CNKI)数据库,以查找比较3D打印人工椎体与传统钛网笼(TMC)在单节段颈椎前路椎体切除融合术(SL-ACCF)中的随机对照试验(RCT)或队列研究。从符合条件的研究中收集手术时间、术中失血量、椎体下沉情况、术前及末次随访时的C2-C7 Cobb角、日本骨科协会(JOA)评分和视觉模拟量表(VAS)评分,进行荟萃分析。

结果

我们纳入了6项队列研究,共341例患者。荟萃分析结果显示,3D组的手术时间比传统TMC组短(=0.04),且TMC组椎体下沉(≥3 mm)比3D组更严重(<0.0001)。在末次随访时,3D组的颈椎C2-C7 Cobb角大于TMC组。

结论

本荟萃分析表明,在单节段颈椎前路椎体切除融合术中,3D打印人工椎体在缩短手术时间、维持术后椎体高度以及恢复颈椎矢状面平衡方面优于传统TMC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be3b/9875138/78af1fb765c0/fsurg-09-1077551-g001.jpg

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