Orthopaedics of Zigong Fourth People's Hospital, Zigong, 643000, Sichuan, China.
Respiratory Medicine of Zigong Fourth People's Hospital, Zigong, 643000, Sichuan, China.
BMC Musculoskelet Disord. 2024 Aug 21;25(1):656. doi: 10.1186/s12891-024-07750-1.
To investigate the clinical significance of using 3D printing guides in modified unilateral puncture percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCF), and to explore a new method for preventing paravertebral vein leakage during PVP in conjunction with a previous study of the optimal puncture-side bone cement/vertebral volume ratio(PSBCV/VV%).
This retrospective study analyzed 99 patients who underwent unilateral puncture PVP between January 2023 and December 2023. Patients were divided into a guide plate group (46 patients) and a conventional group (53 patients). The guide plate group underwent modified unilateral puncture PVP with the guidance of 3D printing guides, while the conventional group underwent unilateral puncture PVP using the conventional pedicle approach. The distribution of bone cement, surgical outcomes, and the occurrence of cement leakage into paravertebral veins were observed in both groups.
The guide plate group had significantly shorter operating time and required fewer fluoroscopies compared to the conventional group. The amount of bone cement volume (BCV) used in the guide plate group was higher, but the amount of bone cement volume on the puncture side(PSBCV), the PSBCV/VV%, and the rate of paravertebral vein leakage were lower in the guide plate group compared to the conventional group (P < 0.05). Within each group, significant improvements in anterior vertebral margin height, Cobb angle, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) were observed at 1 day and 1 month postoperatively compared to preoperative values (P < 0.05).
Using 3D printing guides in modified unilateral puncture PVP is a safe and effective method for treating OVCF. And it has the advantages of short operation time, less fluoroscopy, even distribution of bone cement, and a low rate of paravertebral vein leakage.
探讨 3D 打印导板在改良单侧入路经皮椎体后凸成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）中的临床意义，并结合前期研究的最佳单侧骨水泥/椎体体积比（PSBCV/VV%）探讨一种预防 PVP 过程中椎旁静脉渗漏的新方法。
回顾性分析 2023 年 1 月至 12 月期间 99 例行单侧入路 PVP 治疗的 OVCF 患者，按手术方法不同分为导板组（46 例）和常规组（53 例）。导板组采用 3D 打印导板引导下改良单侧入路 PVP，常规组采用传统单侧入路 PVP。观察两组患者骨水泥分布、手术效果及椎旁静脉渗漏情况。
导板组手术时间和透视次数均明显短于常规组，而导板组骨水泥容积（BCV）使用量高于常规组，但导板组单侧骨水泥容积（PSBCV）、PSBCV/VV%及椎旁静脉渗漏发生率均低于常规组（P<0.05）。两组患者术后 1 天和 1 个月的椎体前缘高度、Cobb 角、视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分均明显优于术前（P<0.05）。
改良单侧入路 PVP 中使用 3D 打印导板是治疗 OVCF 的一种安全有效的方法，具有手术时间短、透视次数少、骨水泥分布均匀、椎旁静脉渗漏发生率低等优点。
