Lu Yilin, Si Gao, Bai Mingxiao, Wang Yongqiang, Tian Yun, Li Weishi, Yu Miao, Wang Yu
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.
Orthop Surg. 2025 Jul;17(7):2038-2047. doi: 10.1111/os.70074. Epub 2025 May 22.
Ankylosing spondylitis (AS) often presents with spinal kyphosis, and pedicle subtraction osteotomy (PSO) is a common surgical technique for correcting AS-related kyphosis. However, after PSO, the posterior column lacks rigid bone support, potentially leading to intervertebral disc mobility and loss of correction. This study aims to introduce a novel 3D-printed laminae for the treatment of AS-related kyphosis.
This is a retrospective cohort study. A total of 48 patients receiving posterior correction surgeries between December 2021 and January 2022 were included and divided into two groups according to whether they accepted the 3D-printed laminae. We propose a novel approach using 3D-printed laminae to enhance posterior column stability and reduce deformity loss. Sixteen patients receiving 3D-printed laminae and 32 patients who did not receive that device. We collected preoperative and postoperative radiographic parameters, perioperative data, and patient-reported clinical scores. Statistical analysis involved independent sample t tests or randomization tests for continuous variables and chi-square tests for categorical variables.
In the implanted group, kyphosis was corrected from 75.88° preoperatively to 27.06° postoperatively, and in the unimplanted group, from 70.98° to 28.42°. At the last follow-up, the ΔGK (global kyphosis) was 1.76° in the implanted group and 2.50° in the unimplanted group. PJA was 9.77° in the implanted group and 15.45° in the unimplanted group, showing significant differences. Two patients in the unimplanted group experienced sagittal reconstruction failure. Health-related quality of life (HRQoL) scores improved in the implanted group, with back pain scores of 2.63 and Oswestry Disability Index (ODI) scores of 13.50.
Our study introduces a novel 3D-printed laminae technique for AS-related kyphosis, aiding in maintaining sagittal balance. Patients reported improved subjective outcomes, including reduced pain and better HRQoL.
强直性脊柱炎（AS）常伴有脊柱后凸，经椎弓根截骨术（PSO）是矫正AS相关后凸的常用手术技术。然而，PSO术后，后柱缺乏刚性骨支撑，可能导致椎间盘活动度增加和矫正丢失。本研究旨在介绍一种用于治疗AS相关后凸的新型3D打印椎板。
这是一项回顾性队列研究。纳入2021年12月至2022年1月期间接受后路矫正手术的48例患者，并根据是否接受3D打印椎板分为两组。我们提出了一种使用3D打印椎板来增强后柱稳定性并减少畸形丢失的新方法。16例患者接受了3D打印椎板，32例患者未接受该装置。我们收集了术前和术后的影像学参数、围手术期数据以及患者报告的临床评分。统计分析包括对连续变量进行独立样本t检验或随机化检验，对分类变量进行卡方检验。
植入组的后凸角度从术前的75.88°矫正至术后的27.06°，未植入组从70.98°矫正至28.42°。在最后一次随访时，植入组的ΔGK（整体后凸）为1.76°，未植入组为2.50°。植入组的PJA为9.77°，未植入组为15.45°，差异有统计学意义。未植入组有2例患者出现矢状面重建失败。植入组的健康相关生活质量（HRQoL）评分有所改善，背痛评分为2.63，奥斯维斯特里残疾指数（ODI）评分为13.50。
我们的研究介绍了一种用于治疗AS相关后凸的新型3D打印椎板技术，有助于维持矢状面平衡。患者报告主观结果有所改善，包括疼痛减轻和HRQoL提高。
