摘要
目的:探究3D打印数字技术辅助改良交叉经皮穿刺椎体成形术（PVP）对重度骨质疏松性椎体压缩骨折（SOVCF）患者脊柱-骨盆矢状面平衡状态的影响。方法:回顾性分析2017年3月至2020年5月上海中医药大学附属光华医院收治的SOVCF患者（166例），根据治疗方案，将患者分为改良PVP组（83例）和PVP组（83例）。通过对比法分析3D打印数字技术辅助改良交叉PVP的疗效及其对患者脊柱-骨盆矢状面平衡状态的影响。结果:改良PVP组患者的手术时间、穿刺定位时间以及透视次数均较PVP组更小（P<0.05）；改良PVP组患者的总有效概率较PVP组更大（P<0.05）；与术前相比，两组患者术后12个月VAS评分以及ODI评分均显著减小（P<0.05）；与术前相比，两组患者术后12个月JOA评分均显著增大（P<0.05）；术后12个月，与PVP组相比，改良PVP组患者的TK、C7-S1SVA以及PT均更小（P<0.05），SS更大（P<0.05）；术后12个月，与PVP组相比，改良PVP组患者的PF、PR、GH、VT以及SF均更大（P<0.05），BP更小（P<0.05）；改良PVP组骨水泥向锥旁及锥前少量渗漏的患者比例较PVP组更小（P<0.05）。结论:3D打印数字技术辅助改良交叉PVP治疗SOVCF患者，可缩短手术以及穿刺定位时间、减少透视次数，显著减轻疼痛，腰椎功能恢复良好，显著改善脊柱-骨盆矢状面平衡状态以及生存质量，降低骨水泥渗漏概率。
Abstract
Objective:To explore the effects of 3D printing digital technology-assisted modified cross percutaneous vertebroplasty (PVP) on the spine-pelvic sagittal balance of patients with severe osteoporotic vertebral compressive fracture (SOVCF).Methods:The patients with SOVCF (166 cases) admitted to Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 2017 to May 2020 were retrospectively analyzed, and according to the treatment protocol, the patients were divided into modified PVP group (83 cases) and PVP group (83 cases). The effect of 3D printing digital technology-assisted modified cross-PVP and its effect on the patient's spine-pelvic sagittal balance state were analyzed by the contrast method.Results:The operation time, puncture positioning time and times of fluoroscopy in the modified PVP group were shorter than those in the PVP group (P<0.05); The total effective probability of patients in the modified PVP group was greater than that in the PVP group (P<0.05). Compared with before operation, the VAS score and ODI score of the two groups decreased significantly 12 months after operation (P<0.05). Compared with before operation, the JOA score of the two groups increased significantly 12 months after operation (P<0.05); At 12 months after operation, compared with the PVP group, the TK, C7-S1SVA and PT of the modified PVP group were smaller (P<0.05), and the SS was larger (P<0.05); At 12 months after operation, compared with the PVP group, the PF, PR, GH, VT and SF of the modified PVP group were all larger (P<0.05), and the BP was smaller (P<0.05); The proportion of patients with a small amount of bone cement leaking to the paracone and anterior cone in the modified PVP group was smaller than that in the PVP group (P<0.05).Conclusions:3D printing digital technology assists the improvement of cross PVP in the treatment of SOVCF patients, which can shorten the operation and puncture positioning time, reduce the number of fluoroscopy, significantly reduce pain, restore lumbar spine function well, significantly improve the spine-pelvic sagittal balance and the quality of life, and reduce the probability of bone cement leakage.
基金项目
上海市长宁区科学技术委员会项目(NKW2018Y13)
上海市科学委员会项目(20Y21903200)
万方数据