| 余海林,顾小荣,郑贵浩.3D打印个性化导板辅助后路寰枢椎置钉治疗寰枢椎脱位并齿突骨折[J].脊柱外科杂志,2024,22(2):111-116. |
3D打印个性化导板辅助后路寰枢椎置钉治疗寰枢椎脱位并齿突骨折  点此下载全文 (Fulltext) |
| 余海林1 顾小荣2 郑贵浩1 |
1. 上饶市人民医院骨科, 上饶 334099;
2. 广丰区中医院骨科, 上饶 334699 |
| 基金项目：江西省卫生健康委员会科技计划项目（202312267） |
| DOI：10.3969/j.issn.1672-2957.2024.02.007 |
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| 摘要： |
| 目的 评价3D打印个性化导板辅助后路寰枢椎置钉治疗寰枢椎脱位并齿突骨折的临床疗效。 方法 选取2018年1月—2022年6月在上饶市人民医院接受治疗的20例寰枢椎脱位并齿突骨折患者，按照随机数字表法分为3D组和对照组，每组10例，3D组在3D打印个性化导板辅助下置钉，对照组采用徒手置钉。记录并比较2组手术时间、置钉时间、术中出血量、术中透视次数、置钉优良率及并发症发生情况。术前和术后1、6、12个月时采用疼痛视觉模拟量表（VAS）评分评估疼痛程度，采用日本骨科学会（JOA）评分评估颈椎功能。术后复查CT评价螺钉位置准确性。 结果 所有手术顺利完成，所有患者术后随访＞ 6个月。术中共置入椎弓根螺钉80枚，无血管、神经损伤等并发症发生。3D组手术时间、置钉时间、术中出血量、术中透视次数、置钉优良率明显优于对照组，差异均有统计学意义（P ＜ 0.05）。2组术后各随访时间点VAS评分和JOA评分较术前明显改善，3D组术后6、12个月VAS评分及术后1、6、12个月JOA评分较对照组改善更明显，差异均有统计学意义（P ＜ 0.05）。 结论 3D打印个性化导板辅助后路寰枢椎置钉治疗寰枢椎脱位并齿突骨折可显著提升安全性和便捷性。 |
| 关键词：寰椎|枢椎|脱位|脊柱骨折|内固定器|计算机辅助设计|成像，三维 |
| 3D printing personalized guided plate assisted posterior atlantoaxial screw placement in treatment of atlantoaxial dislocation with odontoid fracture Fulltext |
| Yu Hailin Gu Xiaorong Zheng Guihao |
1. Department of Orthopaedics, Shangrao People's Hospital, Shangrao 334099, Jiangxi, China;
2. Department of Orthopaedics, Guangfeng District Hospital of Traditional Chinese Medicine, Shangrao 334699, Jiangxi, China |
| Fund Project: |
| Abstract: |
| Objective To evaluate the clinical effect of 3D printing personalized guided plate assisted posterior atlantoaxial screw placement in the treatment of atlantoaxial dislocation with odontoid fracture. Methods From January 2018 to June 2022，a total of 20 patients diagnosed as atlantoaxial dislocation with odontoid fracture treated in Shangrao People’s Hospital were enrolled and divided into the 3D group and the control group according to the random number table，with 10 cases in each group. The screws placement was assisted by 3D printing personalized guided plate in the 3D group，while the control group with freehand. The operation time，screw placement time，intraoperative blood loss，intraoperative fluoroscopy frequency，excellent and good rate of screw placement and complications were recorded and compared between the 2 groups. At pre-operation and postoperative1，6，and 12 months，the pain intensity was assessed by visual analogue scale（VAS） score，and the cervical function was assessed by Japanese Orthopaedic Society（JOA） score. The accuracy of screw position was evaluated by CT after operation. Results All the operations were successfully completed，and all the patients were followed up for more than 6 months. A total of 80 pedicle screws were inserted during the operation，and no complications such as vascular and nerve injury occurred. The operation time，screw placement time，intraoperative blood loss，intraoperative fluoroscopy frequency and excellent and good rate of screw placement in the 3D group were significantly better than those in the control group，and the differences were statistically significant（P ＜ 0.05）. The VAS and JOA scores of the 2 groups were significantly improved at each follow-up time point after surgery，and the VAS score at postoperative 6 and 12 months and JOA scores at postoperative 1，6 and 12 months in the 3D group were significantly improved compared with the control group，all with a statistical significance（P ＜ 0.05）. Conclusion 3D printing personalized guided plate technology can significantly improve the safety and convenience of posterior cervical atlantoaxial screw placement in the treatment of atlantoaxial dislocation with odontoid fracture. |
| Keywords:Atlas|Axis|Dislocations|Spinal fractures|Internal fixators|Computer-aided design|Imaging,three-dimensional |
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