3D打印技术在腰椎滑脱椎体椎弓根螺钉置入技术中应用.docVIP

3D打印技术在腰椎滑脱椎体椎弓根螺钉置入技术中应用 　　【摘要】 目的：探讨3D打印技术在滑脱腰椎椎体中椎弓根钉置入过程中的应用价值。方法：选取本院2014年7月-2015年6月间因腰椎滑脱施行手术的40例患者分为两组，每组各20例。手术方案均采用传统腰椎后路椎板切除椎管减压椎间植骨融合椎弓根钉内固定术（PLIF）手术，传统徒手穿刺组采用传统徒手穿刺完成椎弓根钉置入，3D打印组术前进行3D实体腰椎模型的打印，记录两组在滑脱椎体椎弓根钉置入过程中的工作时间、穿刺次数，均在术后复查CT以判断椎弓根钉置入的准确性。结果：应用3D打印组在滑脱椎体中置入单个椎弓根的平均时间为（5.60±1.85）min，明显短于传统徒手穿刺组的（8.10±1.63）min；穿刺次数平均为（1.20±0.20）次，少于传统徒手穿刺组的（1.80±0.50）次；术后CT平扫提示3D打印组的38枚（95.00%）椎弓根螺钉完全位于椎弓根内，准确率明显高于传统徒手组的80.00%，两组比较差异均有统计学意义（P0.05）。结论：应用3D打印技术有助于椎弓根螺钉置入术前计划的制定，在滑脱腰椎椎体椎弓根钉的置入过程中可有效减少置钉时间并且明显提高置钉的准确性。 　　【关键词】 3D打印； 腰椎滑脱； 椎弓根螺钉技术 　　【Abstract】 Objective：To discuss the value of the 3D Printing Technology in lumbar spondylolisthesis pedicle screws.Method：40 patients with lumbar spondylolisthesis were selected in our hospital from July 2014 to June 2015，they were divided into two groups，20 cases in each group.All patients were instrumented with posterior lumber interbody fusion（PLIF），the conventional hand puncture group was treated by traditional method of pedicle screws，the 3D printing group was treated by the help of 3D printing technology. The finish time of single pedicle screw and the number of replacement times were recorded， all the position of perdicle screw of spondylolisthesis were observed by CT scan to evaluate the screw placement accuracy.Result：The finish time of single screw in 3D printing group was （5.60±1.85）min，which was shorter than（8.10±1.63）min of conventional hand puncture group；the number of replacement times in 3D printing group was （1.20±0.20）times，which was less than（1.80±0.50）times of conventional hand puncture group；according to the CT results， the excellent rate of pedicle screw position in 3D printing group was 95.00%，which was higher than 80.00% of the conventional hand puncture group，the differences were statistically significant（P0.05）.Conclusion：Application of 3D printing technology is helpful to the development of the pedicle screw placement plan，can effectively reduce the time of the pedicle screw placement in the cour