摘要
目的 探究人工智能3D打印导板指导进钉点及角度在胸腰椎骨折手术中的应用.方法 选取73例胸腰椎骨折患者分为两组,研究组采用人工智能3D打印导板技术辅助椎弓根螺钉植入术,对照组采用CT评估预测再进行手术.比较两组手术时间、术中X线暴露次数、术中出血量、输血量、置钉数量及置钉准确率及并发症情况;比较两组术前、术后6个月伤椎手术前后高度比、矢状位后凸Cobb角,及胸腰椎日本骨科协会(JOA)评分及视觉模拟评分法(VAS)评分.结果 与对照组比较,研究组手术时间、术中X线暴露次数、出血量、输血量、螺钉矢状面夹角、内倾角差值及进钉点水平位置差值减少;置钉准确率升高(P＜0.05).与术前比较,两组术后伤椎前后高度比、JOA评分升高,矢状位后凸Cobb角、VAS评分降低,且研究组较对照组变化更显著(P＜0.05).两组患者总并发症发生率对比差异无显著性(P＞0.05).结论 利用人工智能3D打印导板指导进钉点及角度,可有效减少手术时间、X线暴露次数及出血情况,提高置钉准确性,手术效果更好.
Abstract
Aim To explore the application of artificial intelligence 3D printing guide to guide the insertion point and angle in thoracolumbar fracture surgery.Methods 73 patients with thoracolumbar vertebral fractures were selected and divided into two groups.The study group used artificial intelligence 3D printing guide plate technology to assist in pedicle screw implantation surgery,while the control group used CT evaluation and prediction before surgery.Compare the surgical time,intraoperative X-ray exposure frequency,intraoperative blood loss,blood transfusion volume,number and accuracy of nail placement,and incidence of complications between two groups;Compare the height ratio before and 6 months after surgery,sagittal kyphosis Cobb angle,as well as the Japanese orthopaedic association(JOA)and visual analog scale(VAS)scores for thoracolumbar spine between two groups.Results Com-pared with the control group,the study group showed a decrease in surgical time,intraoperative X-ray exposure frequency,blood loss,blood transfusion volume,screw sagittal plane angle,difference in internal inclination angle,and difference in horizontal position of the screw insertion point;The accuracy of nail placement increased(P＜0.05).Compared with preoperative results,the height ratio and JOA score of the injured vertebrae in both groups increased after surgery,while the Cobb angle and VAS score of sagittal kyphosis de-creased.Moreover,the changes in the study group were more significant than those in the control group(P＜0.05).There was no significant difference in the total incidence of complications between the two groups of patients(P＞0.05).Conclusion The use of artificial intelligence printing guide to guide the insertion point and angle can effectively reduce the operation time,X-ray exposure times and bleeding,improve the accuracy of nail placement,and lead to better surgical effect.
维普
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