个体化3D打印技术辅助空心加压螺钉治疗AndersonⅡ型齿状突骨折的临床应用

摘要

Objective To observe the clinical effect of individual 3D printing auxiliary compressed hollow screws surgery treating Anderson Ⅱ type odontoid fracture.Methods From January 2015 to December 2016,in Foshan Hospital of TCM,40 patients with Anderson Ⅱ type odontoid fracture criteria were selected,they were divided into two groups by random number table,with 20 cases in each group.Treatment group was given individual 3D printing auxiliary compressed hollow screws surgery,control group was given convention compressed hollow screws way.The operation situation (surgery time,intranperative bleeding,X-ray times and accuracy rate) and postoperative fusion effect (in cluded odontoid fusion rates,loose or screws extraction rates) of two groups were campared.Results On operation situation:intranperative bleeding,X-ray times and accuracy rate in treatment group were better than those in control group,the differences were statistically significant (P ＜ 0.05).On postoperative fusion effect:all patients in treatment group received odontoid fusion,without loose or screws extraction;there were 4 unfusion cases,3 loosing cases and 1 screws extraction case in control group,odontoid fusion rates,loose or screws extraction rates in treatmnet group were better than those in control group,the differences were statistically significant (P ＜ 0.05).Conclusion The method of individual 3D printing auxiliary compressed hollow screws has a guiding role on treating Anderson Ⅱ type odontoid fracture,which is easy for operate,accurate inserting,shortening times and improving fusion rates.%目的 观察个体化3D打印技术辅助空心加压螺钉治疗AndersonⅡ型齿状突骨折的临床效果.方法 选择2015年1月～2016年12月佛山市中医院AndersonⅡ型齿状突基底骨折的40例患,者按随机数字表法分为治疗组和实验组,每组各20例.治疗组患者采用个体化3D打印技术辅助空心加压螺钉置钉术,对照组患者采用常规齿状空心加压螺钉置钉术.比较两组患者手术操作情况(手术时间、术中出血量、透视时间、置钉准确率)以及术后融合效果(包括枢椎愈合情况、螺钉松动或断裂发生率).结果 手术情况:治疗组在手术时间、术中出血量、透视时间和置钉准确率均优于对照组,差异有统计学意义(P＜0.05).术后融合效果:治疗组所有病例均得到骨性融合,无断裂或松动,对照组有4例患者出现骨折不融合,3例伴有螺钉松动,1例出现螺钉断裂,治疗组的骨性融合率、螺钉松动或断裂发生率优于对照组,差异有统计学意义(P＜0.05).结论 个体化3D打印技术导板钉道置钉手术操作简单,置钉精确性高,能减少医生操作时间,提高术后骨折融合率,对临床上治疗AndersonⅡ型齿状突骨折有指导作用.