3D打印经皮导板辅助经皮后凸成形术治疗骨质疏松椎体压缩性骨折

目的:验证3D打印经皮导板辅助经皮后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松椎体压缩性骨折(osteoporosis vertebral compression fractures,OVCFs)的安全性。方法:对2020年11月至2021年8月,采用PKP治疗的60例OVCFs患者进行回顾性分析,男24例,女36例,年龄72～86(76.5±7.9)岁,其中30例采用常规PKP治疗(常规组),30例采用3D打印经皮导板辅助PKP治疗(导板组)。观察术中椎弓根穿刺时间(穿刺针到椎体后缘)及透视次数,手术总时间,总透视次数,骨水泥注入量,并发症(椎管型骨水泥渗漏),比较两组患者术前和术后3 d的视觉模拟评分(visual analogue scale,VAS)及伤椎前缘压缩率。结果:60例患者均成功实施手术,无椎管型骨水泥渗漏并发症发生。导板组椎弓根穿刺时间(10.23±3.15) min,透视次数(4.77±1.07)次,手术总时间(33.83±4.21) min,总透视次数为(12.27±2.61)次;常规组椎弓根穿刺时间(22.83±3.09)...

Percutaneous kyphoplasty assisted by three dimensional printing percutaneous guide plate for the treatment of osteoporotic vertebral compression fractures

Objective To verify the safety of three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures(OVCFs).Methods The clinical data of 60 patients with OVCFs treated by PKP from November 2020 to August 2021 were retrospectively analyzed. There were 24 males and 36 females,aged from 72 to 86 years old with an average of (76.5±7.9) years. Routine percutaneous kyphoplasty was performed in 30 cases (conventional group) and three dimensional printing percutaneous guide plate assisted PKP was performed in 30 cases (guide plate group). Intraoperative pedicle puncture time (puncture needle to posterior vertebral body edge) and number of fluoroscopy,total operation time,total number of fluoroscopy,amount of bone cement injection,and complication (spinal canal leakage of bone cement) were observed. The visual analogue scale (VAS) and the anterior edge compression rate of the injured vertebra were compared before operation and 3 days after operation between two groups.Results All 60 patients were successfully operated without complication of spinal canal leakage of bone cement. In the guide plate group,the pedicle puncture time was(10.23±3.15) min and the number of fluoroscopy was(4.77±1.07) times,the total operation time was (33.83±4.21) min,the total number of fluoroscopy was(12.27±2.61) times;and in the conventional group,the pedicle puncture time was (22.83±3.09) min and the number of fluoroscopy was (10.93±1.62) times,the total operation time was(44.33±3.57) min,the total number of fluoroscopy was(19.20±2.67) times. There were statistically significant differences in the pedicle puncture time,intraoperative number of fluoroscopy,the total operation time,and the total number of fluoroscopy between the two groups(P<0.05). There was no significant difference in amount of bone cement injection between the two groups(P>0.05). There were no significant differences in VAS and the anterior edge compression rate of the injured vertebra at 3 days after operation between two groups(P>0.05).Conclusion Three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty is safe and reliable,which can reduce the number of fluoroscopy,shorten the operation time,and decrease the radiation exposure of patients and medical staff,and conforms to the concept of precise orthopaedic management