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

doi:10.3877/cma.j.issn.2096-0263.2023.05.002

Abstract

Abstract:

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.

Key words: 3D printing, Digital technology, Percutaneous vertebroplasty, Severe osteoporotic vertebral compression fracture, Spine-pelvic sagittal balance

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]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(05): 263-268.

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Figures/Tables 6

References 21

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组别	例数	年龄（岁，±s）	性别[例（%）]		病程（年，±s）	随访时间（月，±s）	手术时间（min，±s）
组别	例数	年龄（岁，±s）	男性	女性	病程（年，±s）	随访时间（月，±s）	手术时间（min，±s）
改良PVP组	83	71.01±5.14	29（34.94）	54（65.06）	10.52±2.76	13.61±2.04	26.89±3.25
PVP组	83	72.27±4.36	31（37.35）	52（62.65）	10.89±3.04	13.80±2.12	30.97±3.38
统计值		t=1.703	χ²=0.104		t=0.821	t=0.588	t=7.927
P值		0.090	0.747		0.413	0.557	<0.001
组别	例数	伤椎部位[例（%）]			骨密度（g/cm²，±s）	骨折类型[例（%）]			穿刺定位时间（min，±s）	术中透视次数（次，±s）
组别	例数	L₁~L₂	T₁₀	T₁₁~T₁₂	骨密度（g/cm²，±s）	锲形	双凹形	扁平型	穿刺定位时间（min，±s）	术中透视次数（次，±s）
改良PVP组	83	31（37.35）	11（13.25）	41（49.40）	0.59±0.08	19（22.89）	30（36.14）	33（39.76）	7.89±1.07	8.67±1.30
PVP组	83	37（44.58）	8（9.64）	38（45.78）	0.58±0.05	17（20.48）	36（43.37）	30（36.14）	15.72±1.83	13.61±1.85
统计值		χ²=1.117			t=0.966	χ²=0.793			t=33.651	t=19.904
P值		0.572			0.336	0.673			<0.001	<0.001

组别	例数	年龄（岁，±s）	性别[例（%）]		病程（年，±s）	随访时间（月，±s）	手术时间（min，±s）
组别	例数	年龄（岁，±s）	男性	女性	病程（年，±s）	随访时间（月，±s）	手术时间（min，±s）
改良PVP组	83	71.01±5.14	29（34.94）	54（65.06）	10.52±2.76	13.61±2.04	26.89±3.25
PVP组	83	72.27±4.36	31（37.35）	52（62.65）	10.89±3.04	13.80±2.12	30.97±3.38
统计值		t=1.703	χ²=0.104		t=0.821	t=0.588	t=7.927
P值		0.090	0.747		0.413	0.557	<0.001
组别	例数	伤椎部位[例（%）]			骨密度（g/cm²，±s）	骨折类型[例（%）]			穿刺定位时间（min，±s）	术中透视次数（次，±s）
组别	例数	L₁~L₂	T₁₀	T₁₁~T₁₂	骨密度（g/cm²，±s）	锲形	双凹形	扁平型	穿刺定位时间（min，±s）	术中透视次数（次，±s）
改良PVP组	83	31（37.35）	11（13.25）	41（49.40）	0.59±0.08	19（22.89）	30（36.14）	33（39.76）	7.89±1.07	8.67±1.30
PVP组	83	37（44.58）	8（9.64）	38（45.78）	0.58±0.05	17（20.48）	36（43.37）	30（36.14）	15.72±1.83	13.61±1.85
统计值		χ²=1.117			t=0.966	χ²=0.793			t=33.651	t=19.904
P值		0.572			0.336	0.673			<0.001	<0.001

组别	例数	疗效			总有效
组别	例数	显效	有效	无效	总有效
改良PVP组	83	50（60.24）	30（36.14）	3（3.61）	80（96.39）
PVP组	83	42（50.60）	24（28.92）	17（20.48）	66（79.52）
χ²值		1.561	0.988	11.142	11.142
P值		0.212	0.32	0.001	0.001

组别	例数	疗效			总有效
组别	例数	显效	有效	无效	总有效
改良PVP组	83	50（60.24）	30（36.14）	3（3.61）	80（96.39）
PVP组	83	42（50.60）	24（28.92）	17（20.48）	66（79.52）
χ²值		1.561	0.988	11.142	11.142
P值		0.212	0.32	0.001	0.001

评分	例数	VAS评分		ODI评分		JOA评分
评分	例数	术前	术后12个月	术前	术后12个月	术前	术后12个月
改良PVP组	83	6.32±1.73	0.74±0.30^*	38.75±3.81	10.53±2.80^*	13.67±2.28	24.31±2.34^*
PVP组	83	6.25±1.77	0.78±0.39^*	38.89±4.06	11.06±3.18^*	13.59±2.21	24.64±2.29^*
t值		0.258	0.741	0.229	1.14	0.23	0.918
P值		0.797	0.46	0.819	0.256	0.819	0.36

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