【摘要】：目的比較三維打印技術(shù)、ISO-C 3D導(dǎo)航技術(shù)輔助空心加壓螺釘內(nèi)固定治療樞椎齒狀突基底部骨折的臨床效果。方法選取樞椎齒狀突基底部骨折患者36例,隨機(jī)分為三維組和導(dǎo)航組各18例。三維組采用三維打印技術(shù)輔助空心加壓螺釘內(nèi)固定治療,導(dǎo)航組采用ISO-C 3D導(dǎo)航技術(shù)輔助空心加壓螺釘內(nèi)固定治療。記錄兩組術(shù)中出血量、透視時(shí)間及手術(shù)時(shí)間;術(shù)后1周進(jìn)行頸椎CT檢查,觀察螺釘位置并進(jìn)行分級(jí);術(shù)后隨訪(fǎng)6個(gè)月,觀察樞椎愈合情況,統(tǒng)計(jì)螺釘松動(dòng)或斷裂例數(shù)。結(jié)果兩組均順利完成手術(shù)。兩組術(shù)中出血量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),三維組手術(shù)時(shí)間、透視時(shí)間均短于導(dǎo)航組(P均0.01)。三維組螺釘位置分級(jí)為0級(jí)16例、1級(jí)2例、2級(jí)0例,螺釘穿出率為11.11%(2/18);導(dǎo)航組螺釘位置分級(jí)為0級(jí)17例、1級(jí)1例、2級(jí)0例,螺釘穿出率為5.56%(1/18);兩組螺釘穿出率比較P0.05。兩組均完成6個(gè)月隨訪(fǎng),均達(dá)到骨性愈合,隨訪(fǎng)期間均未見(jiàn)明顯螺釘松動(dòng)或斷裂。結(jié)論三維打印技術(shù)、ISO-C 3D導(dǎo)航技術(shù)輔助空心加壓螺釘內(nèi)固定治療樞椎齒狀突基底部骨折效果均較好,置釘準(zhǔn)確率高,術(shù)后融合理想;前者術(shù)中透視時(shí)間及手術(shù)時(shí)間更短。
[Abstract]:Objective to compare the clinical effect of 3D printing technique and ISO-C 3D navigation technique in the treatment of axial odontoid base fracture with hollow compression screw. Methods 36 patients with fracture of the base of odontoid process of axis were randomly divided into three dimensional group (n = 18) and navigation group (n = 18). Three dimensional printing technique was used to assist the internal fixation of hollow compression screws, and ISO-C 3D navigation technique was used to assist the treatment of the internal fixation of hollow compression screws in the navigation group. Blood loss, fluoroscopy time and operation time were recorded in the two groups. Cervical CT was performed 1 week after operation, screw position was observed and graded. Postoperative follow-up for 6 months was performed to observe the union of axis and count the number of loose or broken screws. Results the operation was completed successfully in both groups. There was no significant difference in intraoperative bleeding volume between the two groups (P0.05). The operation time and fluoroscopy time in 3D group were shorter than those in navigation group (P0.01). In the 3D group, 16 cases were classified as 0 grade, 2 cases as grade 1 and 0 as grade 2. The perforation rate of screws was 11.11% (2 / 18). In the navigation group, 17 cases were classified as 0 grade, 1 case was grade 1, 0 case was grade 2, the rate of screw perforation was 5.56% (1 / 18). The two groups were followed up for 6 months, all of them were bony healing, and there was no obvious screw loosening or fracture during the follow-up. Conclusion Three-dimensional printing technique and ISO-C 3D navigation technique combined with hollow compression screw fixation are effective in the treatment of axial odontoid base fracture with high accuracy and ideal fusion. The time of fluoroscopy and operation is shorter in the former.
【作者單位】： 佛山市中醫(yī)院;
【基金】：佛山市醫(yī)學(xué)攻關(guān)項(xiàng)目(2015AB00332)
【分類(lèi)號(hào)】：R687.3
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本文編號(hào)：2386228