3D打印辅助经皮椎体成形术联合体位复位治疗骨质疏松性椎体骨折的效果观察

Effect observation of 3D printing assisted percutaneous vertebroplasty combined with postural reduction in treatment of patients with osteoporotic vertebral fractures

  • 摘要:
      目的  观察3D打印辅助经皮椎体成形术(PVP)联合体位复位治疗骨质疏松性椎体骨折的临床疗效。
      方法  将78例单节段胸腰椎骨质疏松性骨折患者分为2组。3D打印组(n=40)术前行3D打印,非打印组(n=38)采用常规方法,入院后均在体位复位后行PVP治疗。比较2组的临床及影像学指标。
      结果  2组患者均顺利完成手术,3D打印组手术时间、透视次数及骨水泥渗漏率均短于、低于非打印组,差异有统计学意义(P < 0.05)。2组患者术后1 d、末次随访时的视觉模拟评分法(VAS)评分均较术前降低,日本骨科学会(JOA)评分均较术前升高,差异均有统计学意义(P < 0.05)。2组患者术后1 d、末次随访时的伤椎高度比值均较术前升高,差异有统计学意义(P < 0.05)。
      结论  3D打印辅助PVP联合体位复位治疗骨质疏松性椎体骨折效果显著,可减少术中透视次数,缩短手术时间,减少骨水泥渗漏,恢复伤椎高度。

     

    Abstract:
      Objective  To observe the clinical effect of 3D printing assisted percutaneous vertebroplasty (PVP) combined with postural reduction in the treatment of patients with osteoporotic vertebral fractures.
      Methods  Totally 78 patients with single segment thoracolumbar osteoporotic fractures were divided into two groups. The 3D printing group (n=40) received 3D printing before operation, and the non-printing group (n=38) received conventional methods. After admission, all patients received PVP treatment after postural reduction. The clinical and imaging indexes were compared between the two groups.
      Results  The operation was successfully completed in both groups. The operation time, perspective times and bone cement leakage rate of the 3D printing group were significantly shorter and lower than those of the non-printing group (P < 0.05). The Visual Analogue Scale (VAS) scores at 1 day after operation and the last follow-up in both groups were significantly lower than those before operation, and the Japanese Orthopedic Association (JOA) scores were significantly higher than those before operation (P < 0.05). The ratios of injured vertebral height at 1 day after operation and the last follow-up in both groups were significantly higher than those before operation (P < 0.05).
      Conclusion  3D printing, PVP combined with postural reduction is effective in treatment of patients with osteoporotic vertebral fractures, which can reduce intraoperative perspective times, shorten operation time, reduce cement leakage and restore the height of injured vertebrae.

     

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