3D打印导航模板辅助椎弓根螺钉在脊柱侧弯矫形术中的置钉效果

目的:探讨3D打印导航模板辅助椎弓根螺钉在脊柱侧弯矫形术中的置钉效果。方法:回顾性分析2018年1月至2020年6月间采用椎弓根螺钉置钉法治疗的39例脊柱侧弯患者的病例资料,其中采用3D打印导航模板辅助置钉(3D组)18例,常规徒手置钉方法置钉(徒手组)21例。记录并比较2组的置钉时间、置钉出血量、置钉透视次数、置钉等级及准确率、置钉可接受率、置钉并发症和主弯矫形率。采用SPSS 19.0软件进行统计学分析。结果:39例患者均顺利完成术中置钉,术后徒手组4例出现并发症,治疗后症状消失,3D组无相关并发症出现。3D组的置钉时间、置钉出血量、置钉透视次数少于徒手组,置钉等级及准确率、置钉可接受率均优于徒手组,差异有统计学意义(P<0.05);3D组和徒手组主弯矫形率比较差异无统计学意义(P>0.05)。结论:在脊柱侧弯矫形术中采用3D打印导航模板辅助椎弓根螺钉置钉,可显著降低置钉难度、优化术中置钉操作、提升置钉效果,是一种较好的置钉方法。

Effect of 3D printing navigation template assisted pedicle screw placement in scoliosis surgery

Objective To explore the effect of 3D printing navigation template assisted pedicle screw placement in scoliosis surgery.Methods The medical records of 39 patients with scoliosis treated with the pedicle screw placement method between January 2018 and June 2020 were retrospectively analyzed,including 18 cases of screw placement assisted by 3D printing navigation templates(3D group)and 21 cases of screw placement by the conventional free-hand placement method(free-hand group).The time for screw placement,blood loss,fluoroscopy times,grade and accuracy,acceptability,complications and main curve correction rate in the two groups were recorded and compared.SPSS 19.0 software was used for statistical analysis.Results Intraoperative screw placement was successfully completed in all the 39 patients.In the free-hand group complications occurred in four cases and then was eliminated after treatment,and there were no complications in the 3D group;when compared with the free-hand group the 3D group had less screw placement time,blood loss and fluoroscopy times while higher screw placement level,accuracy and acceptability,and the differences were statically significant(P<0.05);there were no obvious differences between the main curve correction rates of the two groups(P>0.05).Conclusion 3D printing navigation template proves to facilitate pedicle screw placement for the scoliosis patient with lowered difficulty,optimized procedure and enhanced effectiveness.