AO型脊柱c型骨折后长节段固定手术规划的患者特异性三维打印脊柱模型

IF 1.1 4区医学 Q3 ORTHOPEDICS

Acta orthopaedica et traumatologica turcica Pub Date : 2022-03-01 DOI:10.5152/j.aott.2021.21332

Anıl Murat Öztürk, Onur Süer, F. Govsa, Mehmet Asım Özer, Ömer Akçalı

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引用次数: 8

摘要

目的:本研究的目的是比较3D模型辅助手术与常规手术治疗AO脊柱c型损伤的手术时间、术中透视暴露、出血量和椎弓根螺钉置入的准确性。方法:回顾性分析32例胸腰椎AO型c型损伤患者。将患者随机分为两组，每组16人，一组采用常规手术，另一组采用3D模型辅助手术。术中记录置入时间、出血量及术中透视暴露情况。此外，根据leach和Wiesner的描述评估螺钉在椎弓根中的状态，并测量术前和术后的区域矢状角(RSA)。结果:结果发现，3D模型辅助手术组置入器械时间(61.9±4.7 min, 268.4±42.7 ml, 16.3±1.9次)与常规手术组(75.5±11.0 min, 347.8±52.2 ml, 19.7±2.4次)比较差异有统计学意义(t = 4.5325, P < 0.0001和t = 4.7109, P < 0.0001和t = 4.4937, P < 0.0001);)虽然常规手术组的螺钉错位率高于3D模型辅助手术组，但唯一有统计学意义的差异是内侧轴位侵占(t = 5.101 P = 0.02)。两组均无严重椎弓根螺钉错位。术后两组RSA角度差异无统计学意义，两组均有明显恢复。结论:本研究结果表明，3D模型可以帮助外科医生在术前和术中了解患者的病理解剖，确定棒的长度、椎弓根螺钉的角度和长度，从而缩短手术时间，减少出血量和透视暴露。证据等级:I级，治疗性研究

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Patient-specific three-dimensional printing spine model for surgical planning in AO spine type-C fracture posterior long-segment fixation

Objective: The aim of this study was to compare duration of surgery, intraoperative fluoroscopy exposure, blood loss and the accuracy of pedicular screw placement between 3D model-assisted surgery and conventional surgery for AO spinal C-type injuries. Methods: In this study 32 patients who were admitted with thoracolumbar AO spinal C-type injuries were included. These patients were divided randomly into two groups of 16 where one group was operated on using conventional surgery and the other group was operated on using 3D model-assisted surgery. During surgery, instrumentation time, amount of blood loss and intraoperative fluoroscopy exposure were recorded. Moreover, the status of the screws in the pedicles was assessed as described by Learch and Wiesner’s and regional sagittal angles (RSA) were measured preop and postoperatively. Results: It was found that there was a statistically significant difference in instrumentation time, blood loss and intraoperative fluoroscopy exposure in the 3D model-assisted surgery group (61.9 ± 4.7 min, 268.4 ± 42.7 ml, 16.3 ± 1.9 times) compared to the conventional surgery group (75.5 ± 11.0 min, 347.8 ± 52.2 mL, 19.7 ± 2.4 times) (t = 4.5325, P < 0.0001 and t = 4.7109, P < 0.0001 and t = 4.4937, P < 0.0001, respectively) Although the screw misplacement rate of the conventional surgery group was higher than that of the 3D model-assisted surgery group, the only statistically significant difference was in the medial axial encroachment (t = 5.101 P = 0.02) . There was no severe misplacement of pedicle screws in either group. There were no statistically significant differences between postoperative RSA angles and were in both groups restored significantly. Conclusion: The results of this study have shown us that the 3D model helps surgeons see patients’ pathoanatomy and determine rod lengths, pedicle screw angles and lengths preoperatively and peroparatively, which in turn shortens operative time, reduces blood loss and fluoroscopy exposure. Level of Evidence: Level I, Therapeutic Study

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来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.