机器人外科学杂志（中英文）2025，Vol.6Issue(3)：355-361,7.DOI:10.12180/j.issn.2096-7721.2025.03.001
3D打印结合椎弓根螺钉双皮质固定治疗合并骨质疏松的腰椎不稳症的临床研究
Clinical study of 3D printing combined with pedicle screw bicortical fixation in the treatment of lumbar spine instability with osteoporosis
摘要
Abstract
Objective:To explore the clinical effect of 3D printing combined with pedicle screw bicortical fixation in the treatment of lumbar spine instability with osteoporosis.Methods:96 patients with lumbar spine instability combined with osteoporosis who were treated in the Sixth Affiliated Hospital of Jinan University from May 2019 to May 2020 were selected.They were divided into the study group(n=48)and the control group(n=48)using a random number table.Both groups were treated with pedicle screw bicortical fixation,while the control group was treated under the assistance of X-ray,and the study group was assisted with 3D printing technology.The operative conditions,length of hospital stay,incidence rate of complications,good and excellent rate of lumbar spine function,bone graft fusion rate,imaging reduction before and after operation(injured vertebra height,anterior edge height compression ratio,Cobb angle),inflammatory-stress factors[C reactive protein(CRP),tumor necrosis factor-α(TNF-α),substance P(SP),prostaglandin E2(PGE2)],VAS score,Oswestry Disability Index(ODI)of patients in the two groups were compared.Results:Compared with the control group,the study group showed a significant decrease in operative time,length of hospital stay,and intraoperative bleeding(P<0.05),while the accuracy of nail placement was significantly increased(P<0.05).There was no statistically significant difference in the simulated height of the injured vertebra,compression ratio of the anterior edge of the injured vertebra,and Cobb angle between 3D printing and the actual values(P>0.05).Compared to that before surgery,the height of the injured vertebrae in the two groups immediately after surgery was significantly increased(P<0.05),while the compression ratio of the anterior edge height of the injured vertebrae and Cobb angle were significantly reduced(P<0.05),and the improvement of patients in the study group was significantly better than that in the control group(P<0.05).The inflammatory factors in the two groups of patients increased after surgery,but the increasing trend of the study group was significantly lower than that in the control group at different timepoints(P<0.05).The VAS and ODI scores of patients in the two groups at 1 month,6 months,and 12 months after operation were lower than those before operation,and the improvement in the scores of the study group at 1 month after surgery was better than that of the control group(P<0.05).There was no statistically significant difference in VAS and ODI scores at 6 months and 12 months after operation(P>0.05).The difference in the good and excellent rate of lumbar spine function and bone graft fusion rate at 12 months after operation between the two groups of patients was not statistically significant(P>0.05),and there was no statistically significant difference in incidence rate of postoperative complications between the two groups of patients(P>0.05).Conclusion:3D printing combined with pedicle screw bicortical fixation has a good clinical effect and fewer complications in the treatment of patients with lumbar spine instability and osteoporosis,it could more effectively reduce the inflammation and stress response caused by surgical trauma,which is of high promotion and application value.关键词
腰椎不稳症/骨质疏松/3D打印/椎弓根螺钉双皮质固定/腰椎功能Key words
Lumbar Spine Instability/Osteoporosis/3D Printing/Bicortical Fixation with Pedicle Screw/Lumbar Spine Function分类
临床医学引用本文复制引用
张史飞,温干军,周植森,陈坚,陈榕生,袁浩彬,孙俊辉,郑帅..3D打印结合椎弓根螺钉双皮质固定治疗合并骨质疏松的腰椎不稳症的临床研究[J].机器人外科学杂志（中英文）,2025,6(3):355-361,7.基金项目
东莞市社会科技发展项目(201950715001274)Social Science and Technology Development Project of Dongguan City(201950715001274) （201950715001274）
