[1]谭波,袁野,谢一方,等.3D打印技术在重度脊柱侧弯截骨联合钉棒内固定矫正治疗中的辅助作用[J].中国医学物理学杂志,2020,37(10):1267-1271.[doi:DOI:10.3969/j.issn.1005-202X.2020.10.010]
　TAN Bo,YUAN Ye,XIE Yifang,et al.Using 3D printing technology to assist the treatment of severe scoliosis by osteotomy combined with internal fixation[J].Chinese Journal of Medical Physics,2020,37(10):1267-1271.[doi:DOI:10.3969/j.issn.1005-202X.2020.10.010]
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3D打印技术在重度脊柱侧弯截骨联合钉棒内固定矫正治疗中的辅助作用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第10期
页码:
1267-1271
栏目:
医学影像物理
出版日期:
2020-10-29

文章信息/Info

Title:
Using 3D printing technology to assist the treatment of severe scoliosis by osteotomy combined with internal fixation
文章编号:
1005-202X（2020）10-1267-05
作者:
谭波; 袁野; 谢一方; 王海涛; 周炳炎; 胡凯
中南大学湘雅医学院附属株洲医院/株洲市中心医院脊柱微创外科， 湖南 株洲 412000
Author(s):
TAN Bo;  YUAN Ye;  XIE Yifang;  WANG Haitao;  ZHOU Bingyan;  HU Kai
Department of Minimally Invasive Spine Surgery, the Affiliated Zhuzhou Hospital of Xiangya Medical College of Central South University/Zhuzhou Central Hospital, Zhuzhou 412000, China
关键词:
重度脊柱侧弯; 3D打印技术; 截骨; 钉棒; 矫形
Keywords:
Keywords: severe scoliosis 3D printing technology osteotomy nail rod orthopedic treatment
分类号:
R318；R681.5
DOI:
DOI:10.3969/j.issn.1005-202X.2020.10.010
文献标志码:
A
摘要:
目的：探讨及分析3D打印技术在重度脊柱侧弯截骨联合钉棒内固定矫正治疗中的辅助作用。方法：选取2017年9月至2019年9月间收治的重度脊柱侧弯患者42例，所有患者均采用截骨联合钉棒内固定矫正治疗，根据是否采用3D打印技术辅助治疗，将用3D打印技术辅助治疗的21例患者设为观察组，未采用的21例患者为对照组。对两组患者围术期指标、置钉数量、置钉准确率及治疗效果等指标进行统计，并分析治疗后并发症发生率。结果：[①]观察组手术时间（115.32±15.28） min、术中出血量（197.52±23.87） mL、术中X光暴露次数（5.24±1.62）次、术后引流量（189.56±19.97） mL等围术期指标优于对照组（P<0.05）。[②]观察组患者置钉106枚，置钉准确数101枚，置钉准确率为95.28%；对照组患者置钉113枚，置钉准确数92枚，置钉准确率为81.42%，两组患者置钉准确率有显著差异（P<0.05）。[③]治疗后，两组患者的脊柱侧弯和后凸Cobb角数据均较治疗前有明显改善（P<0.05），且观察组患者在术后和复查中的角度数据优于对照组，两组之间差异显著（P<0.05）。[④]观察组患者发生1例伤口出血，发生率为4.76%；对照组发生内固定松动1例、神经损伤2例、伤口出血2例、曲轴1例，发生率为28.57%；观察组发生率低于对照组（P<0.05）。结论：对于重度脊柱侧弯患者，在采用截骨联合钉棒内固定矫正治疗基础上，利用3D打印技术进行辅助治疗，能够有效改善患者围术期相关指标，提高置钉准确率，稳固治疗效果，减少并发症发生情况。
Abstract:
Abstract: Objective To explore and analyze the role of 3D printing technology in the treatment of severe scoliosis by osteotomy combined with internal fixation. Methods A total of 42 patients with severe scoliosis who were admitted between September 2017 and September 2019 were enrolled in the study. All patients were treated with osteotomy combined with internal fixation. According to whether 3D printing technology was used to assist treatment, 21 patients receiving auxiliary treatment by 3D printing technology were divided into observation group, and the other patients were taken as control group. The perioperative indicators, number of placed nails, accuracy of nail placement and treatment effect of two groups were recorded, and the incidence of complications after treatment was also analyzed. Results [①] The perioperative indicators such as operation time, intraoperative blood loss, number of intraoperative X-ray exposure times and postoperative drainage in observation group were (115.32±15.28) min, (197.52±23.87) mL, 5.24±1.62 and (189.56±19.97) mL, respectively, better than those in control group (P<0.05). [②] A total of 106 nails were placed in observation group, and 101 nails were accurately placed, with a nail placement accuracy of 95.28%. Only 92 out of 113 nails placed in control group were placed accurately, and the nail placement accuracy was 81.42%. There was significant difference in nail placement accuracy between two groups (P<0.05). [③] After treatment, the scoliosis and kyphosis Cobb angle of two groups were significantly improved (P<0.05), and the angles in observation group after surgery and in reexamination were better than those in control group, with statistical differences (P<0.05). [④] One case of wound bleeding occurred in observation group, and the?omplication?ate was 4.76%. In control group, there were 1 case of internal fixation loosening, 2 cases of nerve injury, 2 cases of wound bleeding, and 1 case of crankshaft, with a?omplication?ate of 28.57%. The observation group had a low incidence of complications than control group (P<0.05). Conclusion Using 3D printing therapy to assist the treatment of severe scoliosis by osteotomy combined with internal fixation can effectively improve perioperative indicators, increase the accuracy of nail placement, stable the treatment effect, and reduce the incidence of complications.

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备注/Memo

备注/Memo:
【收稿日期】2020-03-15 【基金项目】湖南省自然科学基金（2019JJ60086） 【作者简介】谭波，住院医师，研究方向：脊柱微创外科，E-mail: 506387181@qq.com 【通信作者】胡凯，主任医师，E-mail: 1365457778@qq.com
更新日期/Last Update: 2020-10-29