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中华老年骨科与康复电子杂志 ›› 2023, Vol. 09 ›› Issue (05) : 263 -268. doi: 10.3877/cma.j.issn.2096-0263.2023.05.002

脊柱专题

3D打印数字技术辅助改良交叉PVP对重度骨质疏松性椎体压缩骨折脊柱-骨盆矢状面平衡状态的影响
金浪, 石洁, 黄正(), 贾永伟, 张建坡, 魏礼成, 金昊雷   
  1. 200052 上海中医药大学附属光华医院脊柱外科(上海市中医药研究院中西医结合关节炎研究所)
    200052 上海中医药大学附属光华医院放射科
    200052 上海市虹口区江湾镇街道社区卫生服务中心西医全科
  • 收稿日期:2023-01-27 出版日期:2023-10-05
  • 通信作者: 黄正
  • 基金资助:
    上海市长宁区科学技术委员会项目(项目编号:NKW2018Y13); 上海市科学委员会项目(项目编号:20Y21903200)

3D printing digital technology assists the modified cross-PVP on the effect of spine-pelvic sagittal balance in severe osteoporotic vertebral compression fractures

Lang Jin, Jie Shi, Zheng Huang(), Yongwei Jia, Jianpo Zhang, Licheng Wei, Haolei Jin   

  1. Department of Spine, Guanghua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (Institute of Arthritis of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine), Shanghai 200052, China
    Department of Radiology, Guanghua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (Institute of Arthritis of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine), Shanghai 200052, China
    General Department of Western Medicine, Jiangwan Town Community Health Service Center, Hongkou District, Shanghai 200052, China
  • Received:2023-01-27 Published:2023-10-05
  • Corresponding author: Zheng Huang
引用本文:

金浪, 石洁, 黄正, 贾永伟, 张建坡, 魏礼成, 金昊雷. 3D打印数字技术辅助改良交叉PVP对重度骨质疏松性椎体压缩骨折脊柱-骨盆矢状面平衡状态的影响[J/OL]. 中华老年骨科与康复电子杂志, 2023, 09(05): 263-268.

Lang Jin, Jie Shi, Zheng Huang, Yongwei Jia, Jianpo Zhang, Licheng Wei, Haolei Jin. 3D printing digital technology assists the modified cross-PVP on the effect of spine-pelvic sagittal balance in severe osteoporotic vertebral compression fractures[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(05): 263-268.

目的

探究3D打印数字技术辅助改良交叉经皮穿刺椎体成形术(PVP)对重度骨质疏松性椎体压缩骨折(SOVCF)患者脊柱-骨盆矢状面平衡状态的影响。

方法

回顾性分析2017年3月至2020年5月上海中医药大学附属光华医院收治的SOVCF患者(166例),根据治疗方案,将患者分为改良PVP组(83例)和PVP组(83例)。通过对比法分析3D打印数字技术辅助改良交叉PVP的疗效及其对患者脊柱-骨盆矢状面平衡状态的影响。

结果

改良PVP组患者的手术时间、穿刺定位时间以及透视次数均较PVP组更小(P<0.05);改良PVP组患者的总有效概率较PVP组更大(P<0.05);与术前相比,两组患者术后12个月VAS评分以及ODI评分均显著减小(P<0.05);与术前相比,两组患者术后12个月JOA评分均显著增大(P<0.05);术后12个月,与PVP组相比,改良PVP组患者的TK、C7-S1SVA以及PT均更小(P<0.05),SS更大(P<0.05);术后12个月,与PVP组相比,改良PVP组患者的PF、PR、GH、VT以及SF均更大(P<0.05),BP更小(P<0.05);改良PVP组骨水泥向锥旁及锥前少量渗漏的患者比例较PVP组更小(P<0.05)。

结论

3D打印数字技术辅助改良交叉PVP治疗SOVCF患者,可缩短手术以及穿刺定位时间、减少透视次数,显著减轻疼痛,腰椎功能恢复良好,显著改善脊柱-骨盆矢状面平衡状态以及生存质量,降低骨水泥渗漏概率。

Objective

To explore the effects of 3D printing digital technology-assisted modified cross percutaneous vertebroplasty (PVP) on the spine-pelvic sagittal balance of patients with severe osteoporotic vertebral compressive fracture (SOVCF).

Methods

The patients with SOVCF (166 cases) admitted to Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 2017 to May 2020 were retrospectively analyzed, and according to the treatment protocol, the patients were divided into modified PVP group (83 cases) and PVP group (83 cases). The effect of 3D printing digital technology-assisted modified cross-PVP and its effect on the patient's spine-pelvic sagittal balance state were analyzed by the contrast method.

Results

The operation time, puncture positioning time and times of fluoroscopy in the modified PVP group were shorter than those in the PVP group (P<0.05); The total effective probability of patients in the modified PVP group was greater than that in the PVP group (P<0.05). Compared with before operation, the VAS score and ODI score of the two groups decreased significantly 12 months after operation (P<0.05). Compared with before operation, the JOA score of the two groups increased significantly 12 months after operation (P<0.05); At 12 months after operation, compared with the PVP group, the TK, C7-S1SVA and PT of the modified PVP group were smaller (P<0.05), and the SS was larger (P<0.05); At 12 months after operation, compared with the PVP group, the PF, PR, GH, VT and SF of the modified PVP group were all larger (P<0.05), and the BP was smaller (P<0.05); The proportion of patients with a small amount of bone cement leaking to the paracone and anterior cone in the modified PVP group was smaller than that in the PVP group (P<0.05).

Conclusions

3D printing digital technology assists the improvement of cross PVP in the treatment of SOVCF patients, which can shorten the operation and puncture positioning time, reduce the number of fluoroscopy, significantly reduce pain, restore lumbar spine function well, significantly improve the spine-pelvic sagittal balance and the quality of life, and reduce the probability of bone cement leakage.

图1~4 患者行3D打印数字技术辅助改良交叉PVP治疗前后的X线片。图1~2 术前X线片,L2椎体压缩性骨折;图3~4 术后X线片,椎体高度恢复良好,无骨水泥渗漏
表1 两组重度骨质疏松性椎体压缩骨折患者临床资料比较
表2 两组重度骨质疏松性椎体压缩骨折患者治疗效果比较[例(%)]
表3 两组重度骨质疏松性椎体压缩骨折患者的VAS评分、ODI评分以及JOA评分比较(分,±s
表4 两组重度骨质疏松性椎体压缩骨折患者脊柱-骨盆矢状位平衡参数比较(±s
表5 两组重度骨质疏松性椎体压缩骨折患者生存质量评分比较(分,±s
1
Weber A, Huysmans SMD, van Kuijk SMJ, et al. Effectiveness and cost-effectiveness of dynamic bracing versus standard care alone in patients suffering from osteoporotic vertebral compression fractures: protocol for a multicentre, two-armed, parallel-group randomised controlled trial with 12 months of follow-up [J]. BMJ Open, 2022, 12(5): e054315.
2
Yonezawa Y, Yonezawa N, Kanazawa Y, et al. Revision balloon kyphoplasty and vertebra-pediculoplasty using cannulated screws for osteoporotic vertebral fractures with cement dislodgement following conventional balloon kyphoplasty [J]. J Neurointerv Surg, 2022, 14(8): 844-846.
3
李耀,吴爱悯,林焱,等.骨质疏松性胸腰椎压缩骨折椎体成形术后残余背痛影响因素的研究进展[J].中华创伤杂志, 2021, 37(10): 955-960.
4
Zhai GW, Li A, Liu BF, et al. A meta-analysis of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty [J]. Medicine (Madr), 2021, 100(16): e25396.
5
Lou S, Shi X, Zhang X, et al. Percutaneous vertebroplasty versus non-operative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials [J]. Osteoporos Int, 2019, 30(12): 2369-2380.
6
郑博隆,郝定均,林斌,等.天玑"骨科手术机器人辅助与徒手穿刺椎体成形术治疗上胸椎骨质疏松性椎体压缩骨折的疗效比较[J].中华创伤骨科杂志, 2021, 23(1): 20-26.
7
刘小雷,张锦飙,孙中仪,等.骨水泥分布对老年人骨质疏松性椎体压缩骨折经皮椎体成形术疗效的影响[J].中华解剖与临床杂志, 2023, 28(5): 301-307.
8
张翼,寇红伟,尚国伟,等.骨质疏松性椎体压缩骨折行经皮椎体成形术后骨水泥渗漏危险因素分析[J].中华创伤杂志, 2022, 38(5): 396-400.
9
Barabás JI, Ghimessy ÁK, Rényi-Vámos F, et al. [Innovation in medicine: opportunities of 3D modeling and printing for perioperative care of cardio and thoracic surgical patients. Experiences in Hungary] [J]. Orv Hetil, 2019, 160(50): 1967-1975.
10
卞琳杰,陈义钢,巫丹萍,等. 3D打印技术在腹腔镜右半结肠癌根治术前评估中的应用价值[J].中华消化外科杂志, 2020, 19(7): 785-791.
11
张志强,孙立民,张凯,等. 3D数字打印技术在胸椎重度骨质疏松骨折中的临床分析研究[J].中华全科医学, 2020, 18(4): 529-532, 546.
12
常丽鹏,申军,赵敏,等. 3D打印数字技术辅助经皮穿刺椎体成形术治疗重度骨质疏松性椎体压缩骨折的临床效果[J].安徽医学, 2019, 40(12): 1327-1331.
13
赵铁夫,王盛宇,张春晓,等.运动干预对非体外冠状动脉旁路移植术后中年患者健康相关生存质量的影响研究[J].中国全科医学, 2021, 24(14): 1752-1757.
14
BreuilV. Making sure the first osteoporotic fracture is also the last [J]. J Bone Spine, 2020, 87(1): 9-11.
15
AbtahiS, BurdenAM, GeusensP, et al. The association of oral bisphosphonate use with mortality risk following a major osteoporotic fracture in the United Kingdom:Population-based cohort study [J]. J Am Med Dir Assoc, 2020, 21(6): 811-816.
16
蒋建美,包英华,章柯杰,等.改良Wiltse入路椎弓根钉内固定联合经椎弓根植骨对老年骨质疏松性椎体压缩骨折的疗效观察[J].中华内分泌外科杂志, 2021, 15(5): 526-530.
17
范东伟,陈仲强.骨质疏松症与痴呆关系的研究进展[J].中国现代医学杂志, 2021, 31(20): 1-5.
18
潘洪,陈宏,林宗阳,等.骨质疏松性椎体骨折术后血钙、骨代谢状态变化及再骨折风险分析[J].中华内分泌外科杂志, 2022, 16(1): 108-112.
19
Svensson J, Ohlsson C, Karlsson MK, et al. Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men [J]. Osteoporos Int, 2021, 32(11): 2257-2265.
20
Lee BG, Choi JH, Kim DY, et al. Risk factors for newly developed osteoporotic vertebral compression fractures following treatment for osteoporotic vertebral compression fractures [J]. Spine J, 2019, 19(2): 301-305.
21
Yang EZ, Xu JG, Huang GZ, et al. Percutaneousvertebroplasty versus conservative treatment in aged patientswith acute osteoporotic vertebral compression fractures:aprospective randomized controlled clinical study [J]. Spine (Phila Pa 1976), 2016, 41(8): 653-660.
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