郝为民

[摘要] 目的 研究在腰椎退变性疾病治疗中应用基于3D打印的腰椎椎弓根螺钉的临床效果。方法 方便选择2016年1月—2017年12月该院收治的腰椎退变性疾病患者100例，依据应用的治疗方式不同分为观察组、对照组，各50例，其中对照组患者接受微创腰椎椎间固定融合术实施治疗，观察组应用CT详细数据资料联合3D 打印技术制作的导航模板辅助实施腰椎椎弓根螺钉置入治疗，比较两组临床效果。 结果 观察组治疗总有效率为92.00%，对照组总有效率70.00%，差异有统计学意义（χ2=5.632 8，P=0.010 5）;观察组术后1周及术后1个月腰椎功能评分均低于对照组，差异有统计学意义（t=5.331 7、6.822 4，P=0.000 0、0.000 0）;观察组置钉的准确率为96.44%，对照组88.74%，差异有统计学意义（χ2=3.854 5， P=0.001 6）。 结论 在腰椎退变性疾病治疗中应用基于3D打印的腰椎椎弓根螺钉能够提升置钉准确性，提升腰椎功能，有推广意义。

[关键词] 3D打印;腰椎椎弓根螺钉;腰椎退变性疾病;治疗

[中图分类号] R687.3          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0010-04

Application of Lumbar Pedicle Screw Based on 3D Printing in Treatment of Lumbar Degenerative Disease

HAO Wei-min

Department of Spinal Surgery， Heze Hospital， Heze， Shandong Province， 274000 China

[Abstract] Objective To study the clinical effect of lumbar pedicle screws based on 3D printing in the treatment of lumbar degenerative diseases. Methods A total of 100 patients with lumbar degenerative diseases in the hospital from January 2016 to December 2017 were convenient selected and divided into observation group and control group according to different treatment methods. 50 patients in the control group received minimally invasive lumbar interbody fusion. The treatment was performed， and the observation group was assisted in the treatment of lumbar pedicle screw placement using CT detailed data combined with a navigation template made with 3D printing technology. The clinical effects of the two groups were compared. Results The total effective rate was 92.00% in the observation group and 70.00% in the control group，the different was statistically significant（χ2=5.632 8， P=0.010 5）. The lumbar function scores in the observation group were lower than the control group one week after the operation and one month after the operation，the different was statistically significant（t=5.331 7， 6.822 4， P=0.000 0， 0.000 0）; The accuracy rate of nail placement in the observation group was 96.44%， 88.74% in the control group， the different was statistically significant（χ2=3.854 5， P=0.001 6）. Conclusion Application of lumbar pedicle screws based on 3D printing in the treatment of lumbar degenerative diseases can improve the accuracy of nail placement and promote lumbar function.

[Key words] 3D printing; Lumbar pedicle screw; Lumbar degenerative disease; Treatment

非手术方式的保守治疗、外科手术治疗是临床治疗腰椎退变性疾病的重要方法，针对早期腰椎退变性疾病患者，80%以上的患者經非手术保守治疗就能获得满意效果，其中基因治疗、细胞因子治疗是两种应用较广且疗效明显的保守治疗方法[1]。腰椎椎弓根螺钉植入手术是脊柱内固定应用较多一类方法，腰椎椎弓根螺钉生物力学性能良好，能够保证脊柱重建时三柱稳定性，对于腰椎退变性疾病如腰椎骨折等的治疗具有重要意义。腰椎椎弓根螺钉是否能够成功植入主要看植入的腰椎椎弓根螺钉是否从腰椎椎弓根这一狭长的骨性管道准确地经过。……