【摘要】 目的探究3D打印联合椎内固定对退行性腰椎侧弯患者功能障碍、椎体融合率及减压程度的影响。方法前瞻性选取2017年8月至2019年2月广西壮族自治区民族医院骨科收治的退行性腰椎侧弯患者78例。根据随机数字表法分为观察组(n=42)和对照组(n=36)。对照组采用传统椎弓根钉内固定术,观察组采用3D打印联合椎弓根钉内固定。观察2组患者术中手术指标,术后6个月分析视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)、椎体融合率、减压程度。结果观察组手术时间(78.53±9.15) min短于对照组(99.64±9.42) min,术中出血量(150.74±21.33) m L及术后引流量(85.55±8.43) m L低于对照组[(204.62±22.23) m L、(100.23±8.11) m L],差异具有统计学意义(P <0.05)。观察组术后6个月VAS、ODI评分分别为(2.68±1.22)分、(17.00±6.01)分,低于对照组[(3.27±1.13)分、(20.82±6.18)分],差异具有统计学意义(P <0.05)。观察组术后6个月冠状位cobb角、矢状位前凸角、冠状位躯干偏移、矢状位躯干偏移分别为(13.55±3.61)°、(3.20±0.52)°、(12.34±3.68) mm、(17.34±5.31) mm,小于对照组[(14.75±3.51)°、(4.60±0.41)°、(14.54±3.73) mm、(19.76±5.02) mm],差异具有统计学意义(P <0.05)。术后6个月,观察组椎体融合率90.48%、减压程度(93.70±4.65)%,明显高于对照组[72.22%、(91.32±4.13)%],差异具有统计学意义(P <0.05)。结论 3D打印联合椎内固定对退行性腰椎侧弯患者有利于缩短手术时间,减少术中出血量及术后引流量,改善腰椎功能,提高椎体融合率及减压程度。更多还原

【Abstract】 Objective To explore the effect of 3 D printing combined with cone internal fixation on dysfunction,vertebral fusion rate and degree of decompression in patients with degenerative lumbar scoliosis. Methods Seventy-eight patients with degenerative lumbar scoliosis admitted to the orthopedics department of National Hospital of Guangxi Zhuang Autonomous Region from August 2017 to February 2019 were enrolled. According to the random number table method,they were divided into the observation group( 42 cases) and the control group( 36 cases).The control group received traditional pedicle screw internal fixation,and the observation group received 3 D printing combined with pedicle screw internal fixation. The intraoperative surgical indicators were measured. The visual analogue scale( VAS) and Oswestry dysfunction index( ODI),vertebral fusion rate,degree of decompression 6 months after surgery were analyzed. Results The operation time of the observation group was( 78. 53 ± 9. 15) min shorter than that of the control group( 99. 64 ± 9. 42) min. The intraoperative blood loss was( 150. 74 ± 21. 33) m L and the postoperative drainage volume was( 85. 55 ± 8. 43) m L lower than the control group [( 204. 62 ± 22. 23) m L,( 100. 23 ± 8. 11) m L],the differences were statistically significant( P < 0. 05). Six months after operation,the VAS and ODI scores of the observation group were( 2. 68 ±1. 22) pionts,( 17. 00 ± 6. 01) pionts,which were lower than those of the control group[( 3. 27 ± 1. 13) pionts,( 20. 82 ± 6. 18) pionts],the differences were statistically significant( P < 0. 05). Six months after operation,the cobb angle,sagittal lordosis angle,coronal trunk offset,and sagittal trunk offset in the observation group were( 13. 55 ± 3. 61) °,( 3. 20 ± 0. 52) °,( 12. 34 ± 3. 68) mm,( 17. 34 ± 5. 31) mm,which were less than those in the control group [( 14. 75 ± 3. 51) °,( 4. 60 ± 0. 41) °,( 14. 54 ± 3. 73) mm,( 19. 76 ± 5. 02) mm],the differences were statistically significant( P < 0. 05). Six months after surgery,the vertebral fusion rate( 90. 48%) and decompression degree( 93. 70 ± 4. 65) % of the observation group were significantly higher than those of the control group[72. 22%,( 91. 32 ± 4. 13) % ],the differences were statistically significant( P < 0. 05). Conclusion 3 D printing combined with cone internal fixation is conducive to shortening the operation time,reducing the amount of intraoperative bleeding and postoperative drainage,improving the function of the lumbar spine as well as the fusion rate of the vertebral body and the degree of decompression.更多还原