Hanlin Hu, Zhenghao Lu, Xiaowen Gao, Jun Ou, Jiong Wang
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引用次数: 0
Abstract
Objectives: Traditional cortical bone trajectory (CBT) screws in the lumbar spine offer greater holding strength and are well-suited for patients with osteoporosis. However, the screw implantation procedure is challenging and associated with significant risk. This study aimed to assess whether individualized 3D-printing navigation technology provides higher accuracy and better clinical outcomes compared to the free-hand isthmus method for lumbar CBT screw implantation.
Methods: From September 2020 to August 2023, a total of 41 patients who underwent CBT screw surgery were retrospectively collected. Among them, 23 patients underwent the free-hand isthmus method (Group A), while 18 patients underwent the individualized 3D-printing navigation technique (Group B). All imaging and clinical data for these patients were collected in a blinded manner.
Results: During the surgery, 185 CBT screws were implanted into the lumbar spines of 41 patients-78 in Group A and 107 in Group B. After the surgery, the majority of implanted screws (86.5%) were classified as grade 0, indicating satisfactory implantation. Compared to Group A, Group B had fewer screws classified as grade 1 or grade 2 (p = 0.045), indicating higher accuracy in screw implantation. Additionally, Group B also had a shorter operation duration (p = 0.02), fewer fluoroscopy exposures (p < 0.01), and less blood loss (p = 0.03). In addition, compared to Group A, individuals in Group B showed significant improvement in back pain symptoms at both 3 and 6 months (p = 0.01 and <0.01), as well as in physical activity at 3 months (p = 0.02) postoperatively. No significant difference in postoperative complications was observed between the two groups.
Conclusion: Compared to the free-hand isthmus method, lumbar CBT screw implantation with individualized 3D-printing navigation technology shows higher accuracy, shorter operative time, reduced intraoperative fluoroscopy and blood loss, and better clinical outcomes at three months post-surgery.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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