Therapeutic Effect of 3-D Printing Combined with Percutaneous pedicle Screw Fixation for Thoracolumbar Burst Fracture
MU Huai-zhao,ZHAO Jia-jia,YANG Zhao-xin
Department of Trauma and Orthopaedics, Affiliated Hospital of Chengde Medical College, Chengde(067000), Hebei, China
Abstract:
Objective To investigate the feasibility of 3-D printing technique in the treatment of simple thoracolumbar fractures in middle-aged and elderly patients with percutaneous pedicle screw fixation. Methods A retrospective analysis of 28 patients with thoracolumbar burst fractures from January 2014 to June 2016 in our hospital and meeting the surgical conditions, including 11 males and 17 females, aged 52-65 years, averaged 56. 4 years. CT data were collected before surgery in all patients. Three-dimensional reconstruction of the fracture wasperformed in Mimics software, a 1:1 solid model was printed, and the internal fixation program was designed in 3-D model. The percutaneous pedicle screw fixation was performed. . Perioperative indicators (intraoperative blood loss, operation time, drainage, hospitalization time), preoperative and postoperative visual analogue scale (VAS), Cobb angle and spinal canal occupancy rate, and postoperative complications were observed. Results The average operation time was (58.37±10.43) min, the mean blood loss was (51.93 ± 7.65) mL, the average incision drainage was (32.41±12.19) mL, and the average hospital stay was (9.53±2.48) d. All patients. The patients were followed up for 14 to 19 months with an average of 15.7 months. Preoperative The mean preoperative Cobb angle (16.25±4.29)?, postoperative 2 d (5.00±1.64)?, and postoperative 12 months (5.00±1.55)?. The mean spinal canal occupancy rate was (28.18±3.60)%, 2d (9.71±1.80)% after surgery, and 12 months (8.39±1.73)% after surgery. Cobb angle and spinal canal occupancy rate were statistically significant (P<0.05). VAS (8.07±1.05), 1 week (2.75±0.84), and 12 months (1.50±0.88). The postoperative VAS score was significantly lower than that before surgery (P<0.05).There was a statistically significant difference in VAS score between 1 week after operation and 12 months after operation (P<0.05).All patients had no broken nails and loose internal fixation, fractures of the injured vertebrae, infection, deep vein thrombosis of the lower extremities and other complications. One patient suffered from chronic back pain 12 months after operation. Oral non-steroidal analgesic was given, and the symptoms were obviously relieved.Conclusion 3-D printing combined with percutaneous pedicle screw fixation for the treatment of simple lower thoracolumbar fractures in middle-aged and elderly patients can achieve satisfactory early reduction, significantly improve clinical symptoms, increase the stability of the injured vertebrae, and reduce the risk of complications. , has a strong clinical guiding role.
