关键词:

多节段腰椎骨折, 椎弓根螺钉, 3D 打印导板, 角度控制工具, 疗效

Abstract:

Objective To investigate the efficacy of 3D printing guide plate ⁃assisted percutaneous mini⁃ mally invasive pedicle screw placement in the treatment of multi⁃segment lumbar fractures. Methods A total of 60 patients with multi⁃segment lumbar fractures who underwent pedicle screw internal fixation for lumbar spine surgery in our hospital from June 2019 to January 2020 were selected and divided into control group（n = 30）and study group（n = 30）according to the operation plan. Both groups were treated with posterior lumbar pedicle screw place⁃ ment and internal fixation. Otherwise，the control group was treated with freehand pedicle screw placement，and the study group with 3D printing guide plate combined with angle control combined pedicle screw placement tool. The two groups were compared in terms of perioperative period，lumbar vertebra function，pain index，incidence of adverse reactions as well as the Cobb angle of kyphosis and the ratio of the anterior vertebral body height. Results The nail placement time，intraoperative blood loss，operation time，fluoroscopy time and accuracy of nail place⁃ ment in the study group were all significantly better than those in the control group（P<0.05）. At 3 months after operation，the Oswestry disability index（ODI），pain visual analogue（VAS）score and kyphotic Cobb angle in the two groups were decreased compared with those before operation，and the height of anterior vertebral body was increased compared with that before operation. The scores and Cobb angle of kyphosis were lower than those of the control group，and the height of the anterior edge of the vertebral body was higher than that of the control group （P < 0.05）. At last follow⁃up，the ODI and VAS scores of the two groups were decreased compared with 3 months after operation（P < 0.05）. The postoperative kyphotic Cobb angle of the study group was smaller than that of the control group（P < 0.05）. There was no significant difference in the total incidence of complications between the two groups（P < 0.05）. Conclusion 3D printing guide plate assisted percutaneous minimally invasive pedicle screw placement in the treatment of multi⁃segment lumbar vertebral fractures is advantageous for its less radiationand quicker postoperative recovery. It can effectively improve the accuracy of screw placement，with good curative effect and better safety.

Key words:

multi ? segmental lumbar fractures, pedicle screws, 3D printed guides, angle control tools, efficacy