Jiang Wei-Li, Liu Tao, Zhang Qing-Bo, Chen Hui, Bai Jian-Zhong, Wang Shuai, Cheng Jia-Wei, Guo Ya-Long, Zhou Gong, Niu Guo-Qi
Department of Spinal Surgery, the Second Affiliated Hospital to Bengbu Medical College, Bengbu 233002, Anhui, China.
Zhongguo Gu Shang. 2024 Jan 25;37(1):7-14. doi: 10.12200/j.issn.1003-0034.20221151.
To investigate the clinical effect of unilateral percutaneous vertebroplasty (PVP) combined with 3D printing technology for the treatment of thoracolumbar osteoporotic compression fracture.
A total of 77 patients with thoracolumbar osteoporotic compression fractures from October 2020 to April 2022 were included in the study, all of which were vertebral body compression fractures caused by trauma. According to different treatment methods, they were divided into experimental group and control group. Thirty-two patients used 3D printing technology to improve unilateral transpedicle puncture vertebroplasty in the experimental group, there were 5 males and 27 females, aged from 63 to 91 years old with an average of (77.59±8.75) years old. Forty-five patients were treated with traditional bilateral pedicle puncture vertebroplasty, including 7 males and 38 females, aged from 60 to 88 years old with an average of(74.89±7.37) years old. Operation time, intraoperative C-arm X-ray times, anesthetic dosage, bone cement injection amount, bone cement diffusion good and good rate, complications, vertebral height, kyphotic angle (Cobb angle), visual analogue scale(VAS), Oswestry disability index (ODI) and other indicators were recorded before and after surgery, and statistically analyzed.
All patients were followed up for 6 to 23 months, with preoperative imaging studies, confirmed for thoracolumbar osteoporosis compression fractures, two groups of patients with postoperative complications, no special two groups of patients' age, gender, body mass index (BMI), time were injured, the injured vertebral distribution had no statistical difference(>0.05), comparable data. Two groups of patients with bone cement injection, bone cement dispersion rate, preoperative and postoperative vertebral body height, protruding after spine angle(Cobb angle), VAS, ODI had no statistical difference(>0.05). The operative time, intraoperative fluoroscopy times and anesthetic dosage were statistically different between the two groups(<0.05). Compared with the traditional bilateral puncture group, the modified unilateral puncture group combined with 3D printing technology had shorter operation time, fewer intraoperative fluoroscopy times and less anesthetic dosage. The height of anterior vertebral edge, kyphosis angle (Cobb angle), VAS score and ODI of the affected vertebrae were statistically different between two groups at each time point after surgery(<0.05).
In the treatment of thoracolumbar osteoporotic compression fractures, 3D printing technology is used to improve unilateral puncture PVP, which is convenient and simple, less trauma, short operation time, fewer fluoroscopy times, satisfactory distribution of bone cement, vertebral height recovery and kyphotic Angle correction, and good functional improvement.
探讨单侧经皮椎体成形术（PVP）联合3D打印技术治疗胸腰椎骨质疏松性压缩骨折的临床效果。
选取2020年10月至2022年4月收治的77例胸腰椎骨质疏松性压缩骨折患者，均为外伤所致椎体压缩骨折。根据治疗方法不同分为试验组和对照组。试验组32例采用3D打印技术改良单侧经椎弓根穿刺椎体成形术，其中男5例，女27例，年龄63～91岁，平均（77.59±8.75）岁。对照组45例采用传统双侧椎弓根穿刺椎体成形术，其中男7例，女38例，年龄60～88岁，平均（74.89±7.37）岁。记录两组患者手术时间、术中C型臂X线透视次数、麻醉剂量、骨水泥注入量、骨水泥弥散良好率、并发症、椎体高度、后凸角（Cobb角）、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）等指标，于术前及术后进行统计学分析。
所有患者均随访6～23个月，术前影像学检查确诊为胸腰椎骨质疏松性压缩骨折，两组患者术后均无特殊并发症，两组患者年龄、性别、体重指数（BMI）、受伤时间、受伤椎体分布比较，差异无统计学意义（>0.05），具有可比性。两组患者骨水泥注入量、骨水泥弥散率、术前及术后椎体高度、术后脊柱后凸角（Cobb角）、VAS、ODI比较，差异无统计学意义（>0.05）。两组患者手术时间、术中透视次数及麻醉剂量比较，差异有统计学意义（<0.05）。与传统双侧穿刺组比较，3D打印技术改良单侧穿刺组手术时间短，术中透视次数少，麻醉剂量小。术后各时间点两组患者伤椎前缘高度、后凸角（Cobb角）、VAS评分及ODI比较，差异有统计学意义（<0.05）。
在胸腰椎骨质疏松性压缩骨折治疗中，采用3D打印技术改良单侧穿刺PVP，操作简便，创伤小，手术时间短，透视次数少，骨水泥分布满意，椎体高度恢复及后凸角矫正效果好，功能改善良好。
