临床诊疗
目的 探究骨质疏松性椎体压缩骨折治疗中3D打印技术的应用及其效果。方法 选取我院2016年1月—2018年10月收治的90例行经皮椎体成形术治疗的骨质疏松性椎体压缩骨折患者作为研究对象,随机分为常规组45例和实验组45例。常规组采用MR+常规穿刺方法,通过MR引导,注入骨水泥;实验组采用CT+3D打印技术,在应用CT的基础上,借助制作模型的引导,实施精准定位并实施手术治疗,对两组各项围术期治疗指标(手术时间、射线暴露次数、后凸Cobb角改善)和治疗前后的VAS评分、ODI评分以及骨水泥渗漏情况。结果 在手术时间、射线暴露次数、后凸Cobb角改善等围术期治疗指标方面,实验组均要优于常规组,差异有统计学意义(P<0.05)。在骨水泥渗漏发生率方面,常规组为17.78%(8/45),实验组为4.44%(2/45),实验组低于常规组,差异有统计学意义(P<0.05)。在VAS评分、ODI评分方面,常规组和实验组治疗前、治疗后相比差异均无统计学意义(P>0.05)。结论 骨质疏松性椎体压缩骨折经皮椎体成形术治疗中,配合3D打印技术能够有效提升治疗的有效性,促进患者的健康恢复,值得推广应用。
论著
目的 回顾分析椎体成形术(PVP)对于治疗骨质疏松性新鲜椎体压缩骨折(OVCF)患者的疗效。方法 收集2011年1月—2012年6月新鲜OVCF患者伤后两周内行PVP术治疗共34例(51个椎体)。于术前1天、术后3天、1个月、3个月、6个月、12个月予VAS、ODI评分,并行X线检查以测量病椎前、中、后缘的高度和病椎cobb角。结果 纳入研究的34个病例中,患者术后各时间点随访中VAS和ODI评分均较术前1天明显改善(P<0.05)。术后各时间点随访中行X线检查时,术后各次随访中椎体前缘、中段、病椎cobb角均较术前有较为明显的矫正(P<0.05)。结论 应用PVP治疗新鲜OVCF疗效满意,可快速缓解疼痛、改善生活质量和矫正病椎后凸畸形。
Objective To study the efficiency and safety of percutaneous Vertebroplasty(PVP) for the fresh osteoporotic vertebral compression fractures(OVCF). Methods 34 patients (30 females and 4 males), mean age 75.8 years old(75.79±9.32, range 60 to 93 years old) hospitalized between January 2011 to June 2012 were reviewed retrospectively in this study. Evaluation at follow-up time point(1 day before PVP, 3rd day, 1st, 3rd, 6th, 12th month after PVP) included the pain score with VAS, mobility improvement with ODI and the measurement of anterior, middle and posterior height of the fractured vertebra, and kyphotic angle of the fractured vertebra with X-ray image. Results For the 34 patients by followed up 1 year, the mean VAS score and ODI decreased significantly after PVP at any follow-up time compared with the 1 day before operation. Anterior and middle body height and the focal kyphotic angle at any follow-up time after PVP was improved statistically significant compared with the preoperative value(P<0.05). Conclusion Percutaneous vertebroplasty results in prompt pain relief, rapid rehabilitation and kyposis reduction, it is a safe and effective procedure for treating fresh osteoporotic vertebral compression fractures.