| 张愈峰.3D打印导航板在椎间孔镜下腰椎髓核摘除术中的临床应用[J].中国脊柱脊髓杂志,2019,(5):444-448. |
| 3D打印导航板在椎间孔镜下腰椎髓核摘除术中的临床应用 |
| 中文关键词: 3D打印技术 导板 椎间孔镜 临床应用 |
| 中文摘要: |
| 【摘要】 目的：探讨3D技术打印导航板在椎间孔镜下腰椎髓核摘除术中应用的可行性及效果。方法：回顾性分析2016年1月～2017年1月在我院采用椎间孔镜下腰椎髄核摘除术治疗单节段腰椎间盘突出症60例患者，采用随机数字表法分为观察组和对照组，每组各30例。观察组采用3D打印导板辅助穿刺下椎间孔镜下腰椎髓核摘除术，对照组采用单纯椎间孔镜下腰椎髓核摘除术，并对两组的穿刺次数、X线透视次数、手术时间、术后并发症进行对比。两组在术前及术后1d、1周、1个月行腰痛VAS评分（0~100分），术前、术后3个月随访时行Oswestry功能障碍指数（Oswestry dysfunction index，ODI）及改良Macnab疗效评定。结果：患者穿刺次数、X线透视次数、手术时间观察组为（1.17±0.37、2.33±0.75、40.47±7.55min）均低于对照组（5.00±2.15、10.63±3.77、63.67±16.63min），差异有统计学意义（P＜0.01）。术后1d腿痛VAS评分观察组（19.67±8.99）低于对照组（32.00±9.21），差异有统计学意义（P＜0.05）；术后1周及1个月腿痛VAS评分观察组（13.17±10.94、10.50±13.47）、对照组（16.00±11.62、11.50±13.65），差异无统计学意义（P＞0.05）；术后3个月ODI评分观察组（13.20±9.86）%低于对照组（15.73±10.74）%，差异无统计学意义（P＞0.05）；术后改良Macnab疗效评定优良率试验组（90.0%）与对照组（86.7%），差异无统计学意义（P＞0.05）。对照组并发症：神经损伤2例、腰大肌血肿1例、减压不彻底1例，观察组并发症：减压不彻底1例，差异有统计学意义（P＜0.05）。结论：3D技术打印的导板辅助椎间孔镜下腰椎髓核摘除术，可降低穿刺次数、减少X线透视次数、手术时间。 |
3D printing guild platein percutaneous endoscopic lumbar discectomy |
| 英文关键词:3D printing Guide plate Intervertebral foramen Clinical application |
| 英文摘要: |
| 【Abstract】 Objectives: To explore the application of 3D printing guild plate in percutaneous endoscopic lumbar surgery(PELD). Methods: From January 2016 to January 2017, 60 patients were treated with PELD in our hospital. The patients were randomly divided into two groups: observation group and control group, each group had 30 patients. The observation group was treated with PELD assisted by 3D printing guild plate, and the control group was treated by using simple PELD technique. The number of puncture times, X-ray fluoroscopy, operation time, intraoperative blood loss and postoperative complications were compared between the two groups. VAS scores(0-100) were performed before operation and at 1 day, 1 week and 1 month after operation. Oswestry dysfunction index(ODI) and modified Macnab were collected before operation and at 3 mouths follow-up after operation. Results: The number of puncture, the number of X-ray fluoroscopy, operation time, blood loss in the observation group(1.17±0.37, 2.33±0.75, 40.47±7.55) were all significantly lower than those in the control group(5.00±2.15, 10.63±3.77, 63.67±16.63), with the differences being statistically significant(P<0.01). The VAS score in the observation group(19.67±8.99) was significantly lower than that in the control group(32.00±9.21) on the first postoperative day, and the difference was statistically significant(P<0.05); there was no significant difference in the VAS score between the observation groups(13.17±10.94, 10.50±13.47) and the control group(16.00±11.62, 11.50±13.65) at 1 week and 1 month after operation(P>0.05); the ODI score in the observation group(13.20±9.86)% was lower than that in the control group(15.73±10.74)% in three months after operation, with no significant difference(P>0.05); the rate of excellent and good Macnab after surgery evaluation in the observation group(90.0%) was higher than that in the control group(86.7%), and the difference was not statistically significant(P>0.05). Conclusions: PELD assisted by 3D printing guild plate can reduce the number of puncture times, X-ray fluoroscopy, operation time, blood loss and improve function. |
| 投稿时间：2018-05-24 修订日期：2019-01-29 |
| DOI： |
| 基金项目:南通市科技项目（MS22015121） |
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