【摘要】 目的探讨 3D 打印人工椎体在颈椎骨巨细胞瘤 （giant cell tumor of bone,GCTB） 前后联合入路肿瘤切除后重建的临床应用疗效。方法回顾性分析 2015 年 12 月至 2019 年 4 月应用 3D 打印人工椎体在颈椎 GCTB 前后联合入路肿瘤切除后重建的 5 例患者。其中男 2 例,女 3 例;年龄 36～64 岁,平均 46.8 岁。颈椎肿瘤病灶位于 C₄ 1 例、C₅ 1 例、C_6～7 1 例,C₇ 2 例,初次手术 3 例,外院治疗后复发 2 例。记录手术时间、出血量、疼痛视觉模拟评分 （visual analogue score,VAS）、日本骨科协会 （Japanese orthopaedic association,JOA） 颈椎脊髓功能评分、并发症、肿瘤复发情况。结果所有患者手术均顺利完成,术中未发生重要血管神经损伤。3 例行一期手术,2 例行二期手术,总手术时间 220～320 min,平均 （266±40） min,总术中出血量 450～3000 ml,平均 （1550±1105） ml。所有患者均获得随访,随访时间 12～48 个月,平均 26.4 个月,所有病例术后疼痛消失、功能改善,术后 3 个月 VAS 评分 1～2 分,平均 （1.60±0.55） 分,术后 3 个月 JOA 评分13～15 分,平均 （14.20±0.84） 分。未见假体松动、移位、断裂等并发症。所有患者术后未发现局部复发和其它部位转移灶。结论 3D 打印人工椎体在颈椎 GCTB 前后联合入路肿瘤切除后重建的临床应用可获得满意的肿瘤控制及重建效果,可进一步长期随访。更多还原

【Abstract】 Objective To investigate the clinical effect of 3D-printed artificial vertebral body in the reconstruction after cervical giant cell tumor resection by anterior and posterior approach.Methods Five cases with cervical giant cell tumors underwent 3D-printed artificial vertebral body reconstruction after tumor resection by anterior and posterior approach from December 2015 to April 2019.All clinical data were analyzed retrospectively.There were 2 males and 3 females with an average age of 46.8 years （range:36-64 years）.Tumor locations:C₄ in 1 case,C₅ in1 case,C_6-7 in 1 case,C₇ in 2 cases.Three cases underwent initial operations,while two were recurrent cases.Operation time,bleeding volume,visual analogue scale （VAS） and Japanese Orthopaedic Association （JOA） cervical spinal cord function score,complications and tumor recurrence were recorded.Results All operations were successfully completed with no important vascular and nerve injuries during the operation.Three patients underwent primary operation and two patients underwent secondary operation.The total operation time was 220-320 min （range:266±40 min）,and the total intraoperative bleeding volume was 450-3000 ml （range:1550±1105 ml）.All the patients were followed up for 12-48 months （mean:26.4 months）.The pain disappeared and the function improved after operation.The average VAS was （1.60±0.55） （range:1-2） 3 months after operation,while JOA （14.20±0.84）（range:13-15）.No loosening,displacement,fracture,local recurrence or metastasis was found in all patients.Conclusions 3D-printed artificial vertebral body obtains satisfactory clinical effect in the reconstruction after cervical giant cell tumor resection by anterior and posterior approach.Long-term follow-up is recommended.更多还原