使用 3D 打印三角形钛植入物进行骶髂关节融合术的前瞻性试验:5年随访。

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY
Spine Pub Date : 2025-05-01 Epub Date: 2024-09-30 DOI:10.1097/BRS.0000000000005170
Vikas Patel, S Craig Meyer, Don Kovalsky, Harry Lockstadt, Jim Farris, Robert Limoni, Abhineet Chowdhary, Philip Yuan, Casey Langel, Andy Kranenburg, Gabriel Tender
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引用次数: 0

摘要

研究设计前瞻性、多中心、单臂研究,随访 5 年:报告使用3D打印三角钛植入物(TTI)进行骶髂关节融合术(SIJF)后的长期(5年)安全性、有效性和影像学结果,并与固体钛等离子喷涂植入物进行比较:大量文献支持使用 TTI 微创 SIJF 治疗慢性 SIJ 功能障碍:方法:对 51 名受试者进行了带 TTI 的 SIJF,并计划在 3、6、12、24 和 60 个月时进行随访。术后随访包括生活质量问卷调查和功能测试。6个月或12个月时进行一次高分辨率CT扫描,60个月时再次进行扫描。所有 CT 扫描均由一名独立的肌肉骨骼放射科医生进行解读:51 名受试者中有 36 人(71%)接受了 5 年随访。5年后,SI关节疼痛(58.1分[0-100分])、SI关节相关残疾(Oswestry残疾指数[ODI],25.4分)和生活质量(EuroQOL 5D,0.24分,EuroQOL视觉模拟量表,13.4分)均有改善,且没有减弱的迹象。因 SIJ 疼痛而使用阿片类药物的患者比例从基线(57%)到 5 年前(17%)显著下降。身体功能测试结果表明,与基线相比,患者的身体功能得到了持续改善。没有证据表明发生过装置破损、移位或下沉,也很少发生可归因于装置的后期不良事件。对CT扫描的独立分析表明,所有病例的骨质都与植入物相对,90%的病例有骨质桥接的证据,没有证据表明有放射或其他不良骨质反应:为期5年的前瞻性随访显示,使用3D打印TTI进行SIJ融合术可立即、显著、持续地改善疼痛和生活质量,提高身体功能,减少阿片类药物的使用,翻修手术率低。放射学证据显示植入物整合和关节融合:证据等级:二级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants: Five-Year Follow-Up.

Study design: Prospective, multicenter, single-arm study with five-year follow up.

Objective: To report long-term (five years) safety, effectiveness, and radiographic outcomes after sacroiliac (SI) joint fusion (SIJF) with 3D-printed triangular titanium implants (TTI) and compare them with solid titanium plasma spray coated implants.

Summary of background data: A large literature base supports minimally invasive SIJF with TTI for chronic SIJ dysfunction.

Materials and methods: SIJF with TTI was performed in 51 subjects and scheduled follow-up occurred at 3, 6, 12, 24, and 60 months. Postoperative visits included quality of life questionnaires and functional tests. A high-resolution CT scan was performed at either 6 or 12 months, and again at 60 months. All CT scans were interpreted by an independent musculoskeletal radiologist.

Results: Five-year follow-up was available in 36 of 51 subjects (71%). At five years, improvements in SI joint pain [58.1 points (0-100 scale)], SIJ-related disability [Oswestry disability index (ODI), 25.4 points) and quality of life (EuroQOL 5D: 0.24 points and EuroQOL visual analog scale: 13.4 points) were sustained and showed no signs of diminution. The percentage of patients using opioids for SIJ pain decreased markedly from baseline (57%) to five years (17%). Physical function tests showed persistent improvements from baseline. There was no evidence of device breakage, migration or subsidence and few late adverse events occurred attributable to the device. Independent analysis of CT scans showed bone opposed to implants in all cases, and evidence of bone bridging in 90% of cases, and no evidence of radiolucency or other adverse bone reactions.

Conclusions: Prospective five-year follow-up showed that SIJ fusion using 3D-printed TTI resulted in immediate, marked, and persistent improvements in pain and quality of life, with improved physical function, reduced opioid use, and a low rate of revision surgery. Radiographic evidence showed implant integration and joint fusion.

Level of evidence: Level II.

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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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