应用3D打印个体化导板进行S2AI螺钉固定的临床精准性及安全性研究(1)
摘 要：目的 研究应用3D打印个体化导板进行S2AI螺钉固定的临床精准性及安全性。方法 将2016年8月～2017年8月于我院接受S2AI螺钉固定治疗的40例退行性脊柱侧弯患者分为未采用3D打印个体化导板的对照组及应用3D打印个体化导板的观察组各20例，观察患者椎弓根壁损伤发生情况、S2AI螺钉钉道参数。结果 观察组椎弓根壁损伤发生率10.00%，对照组椎弓根壁损伤发生率20.00%，差异有统计学意义(P<0.05)；两组S2AI螺钉钉道参数相比较，观察组尾向偏角、外向偏角、钉道最大长度、钉道在骶骨内长度、髂骨宽度、进钉点与皮肤垂直距离均优于对照组，差异有统计学意义(P<0.05)。结论 应用3D打印个体化导板进行S2AI螺钉固定可降低患者椎弓根壁损伤发生率，提高临床精准性及安全性，值得推广使用。
关键词：3D打印个体化导板；S2AI螺钉固定；临床精准性；安全性
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.004
, http://www.100md.com
文章编号：1006-1959(2018)06-0010-03
Clinical Accuracy and Safety of S2AI Screw Fixation with 3D Printed Individualized Guide Plate
LUO Zhi-gao1，CAO Kai2
(1.Pingxiang Xiangyaping Mine Cooperative Hospital，Pingxiang 337009，Jiangxi，China；
2.Department of Spinal Surgery，the First Affiliated Hospital of Nanchang University，Nanchang 330000，Jiangxi，China)
, 百拇医药
Abstract：Objective To study the clinical precision and safety of S2AI screw fixation using 3D printed individualized guides. Methods 40 patients with degenerative scoliosis treated with S2AI screw fixation in our hospital from August 2016 to August 2017 were divided into control group without 3D printed individualized guide plate and observation group with 3D printed individualized guide plate.20 patients in each group，the occurrence of the pedicle wall injury and the S2AI screw parameters were observed.Results The incidence rate of pedicle wall damage in the observation group was 10.00%，and the incidence of pedicle wall injury in the control group was 20.00%，the difference was statistically significant(P<0.05)；Comparing the two groups of S2AI screws，the tail angle， outward declination，the maximum length of the nail path， the length of the pin canal in the sacrum，the width of the ilium，the vertical distance between the entry point and the skin were all better than those in the control group，the difference was statistically significant(P<0.05)，Conclusion Using 3D to print individual guide plate for S2AI screw fixation can reduce the incidence of pedicle wall injury，improve clinical accuracy and safety，and is worthy of popularization.
, http://www.100md.com
Key words：3D printed personalized guide；S2AI screw fixation；Clinical accuracy；Safety
S2AI螺钉固定是目前治疗腰椎病变常用手段，在实际应用中具有钉道长、内固定物稳定等优点，一经问世就受到了患者的广为青睐[1]。然而，既往采取的徒手置钉虽然能够取得较为理想的疗效，但术后并发症发生率相对较高，大幅延长患者康复时间，所以提高手术操作的精准性及安全性成为临床亟待解决的问题。3D打印个体化导板是一种随着影像技术快速发展而衍生出来的一种辅助置钉手段，将其应用于S2AI螺钉固定中无疑能够取得更为理想的疗效[2]。鉴于此，本次研究围绕应用3D打印个体化导板进行S2AI螺钉固定的临床精准性及安全性展开分析，报告如下。
1 资料与方法
1.1一般资料 将2016年8月～2017年8月于我院接受S2AI螺钉固定治疗的40例退行性脊柱侧弯患者分为未采用3D打印个体化导板的对照组及应用3D打印个体化导板的观察组，各20例。纳入标准：①无代谢性骨病者；②既往无腰骶骨盆手术史者；③临床依从性好者。排除标准：①S2AI螺钉固定禁忌者；②未签署知情同意书者。对照组中男12例，女8例，年龄40～65岁，平均年齡(55.27±1.03)岁，病程时间1.5～7年，平均病程(2.34±0.16)年；症状表现：腰痛14例，活动受限6例。观察组中男15例，女5例，年龄42～65岁，平均年龄(55.25±1.05)岁，病程时间1～7年，平均病程(2.30±0.15)年；症状表现：腰痛15例，活动受限5例。两组腰椎病变患者性别、年龄、病程等一般资料差异比较无统计学意义(P>0.05)，可分组比对。, 百拇医药(罗志高 曹凯)
关键词：3D打印个体化导板；S2AI螺钉固定；临床精准性；安全性
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.004
, http://www.100md.com
文章编号：1006-1959(2018)06-0010-03
Clinical Accuracy and Safety of S2AI Screw Fixation with 3D Printed Individualized Guide Plate
LUO Zhi-gao1，CAO Kai2
(1.Pingxiang Xiangyaping Mine Cooperative Hospital，Pingxiang 337009，Jiangxi，China；
2.Department of Spinal Surgery，the First Affiliated Hospital of Nanchang University，Nanchang 330000，Jiangxi，China)
, 百拇医药
Abstract：Objective To study the clinical precision and safety of S2AI screw fixation using 3D printed individualized guides. Methods 40 patients with degenerative scoliosis treated with S2AI screw fixation in our hospital from August 2016 to August 2017 were divided into control group without 3D printed individualized guide plate and observation group with 3D printed individualized guide plate.20 patients in each group，the occurrence of the pedicle wall injury and the S2AI screw parameters were observed.Results The incidence rate of pedicle wall damage in the observation group was 10.00%，and the incidence of pedicle wall injury in the control group was 20.00%，the difference was statistically significant(P<0.05)；Comparing the two groups of S2AI screws，the tail angle， outward declination，the maximum length of the nail path， the length of the pin canal in the sacrum，the width of the ilium，the vertical distance between the entry point and the skin were all better than those in the control group，the difference was statistically significant(P<0.05)，Conclusion Using 3D to print individual guide plate for S2AI screw fixation can reduce the incidence of pedicle wall injury，improve clinical accuracy and safety，and is worthy of popularization.
, http://www.100md.com
Key words：3D printed personalized guide；S2AI screw fixation；Clinical accuracy；Safety
S2AI螺钉固定是目前治疗腰椎病变常用手段，在实际应用中具有钉道长、内固定物稳定等优点，一经问世就受到了患者的广为青睐[1]。然而，既往采取的徒手置钉虽然能够取得较为理想的疗效，但术后并发症发生率相对较高，大幅延长患者康复时间，所以提高手术操作的精准性及安全性成为临床亟待解决的问题。3D打印个体化导板是一种随着影像技术快速发展而衍生出来的一种辅助置钉手段，将其应用于S2AI螺钉固定中无疑能够取得更为理想的疗效[2]。鉴于此，本次研究围绕应用3D打印个体化导板进行S2AI螺钉固定的临床精准性及安全性展开分析，报告如下。
1 资料与方法
1.1一般资料 将2016年8月～2017年8月于我院接受S2AI螺钉固定治疗的40例退行性脊柱侧弯患者分为未采用3D打印个体化导板的对照组及应用3D打印个体化导板的观察组，各20例。纳入标准：①无代谢性骨病者；②既往无腰骶骨盆手术史者；③临床依从性好者。排除标准：①S2AI螺钉固定禁忌者；②未签署知情同意书者。对照组中男12例，女8例，年龄40～65岁，平均年齡(55.27±1.03)岁，病程时间1.5～7年，平均病程(2.34±0.16)年；症状表现：腰痛14例，活动受限6例。观察组中男15例，女5例，年龄42～65岁，平均年龄(55.25±1.05)岁，病程时间1～7年，平均病程(2.30±0.15)年；症状表现：腰痛15例，活动受限5例。两组腰椎病变患者性别、年龄、病程等一般资料差异比较无统计学意义(P>0.05)，可分组比对。, 百拇医药(罗志高 曹凯)