摘要
目的于腰椎管狭窄症者经皮椎间孔镜手术治疗中使用3D打印技术的可行性以及临床效果进行探讨。方法对2017年6月至2018年12月来三门峡市中心医院就诊的65例腰椎管狭窄症患者进行研究,所有患者均经皮椎间孔镜手术治疗,且采用3D打印技术进行辅助,总结治疗情况和结果。结果本课题65例患者的手术用时为(84.23±10.52)min,手术中的失血量为(29.25±4.33)mL。患者手术中均未出现神经损伤和血管损伤。术后VAS评分小于术前(P<0.05),患者术后的腰腿痛得到明显缓解。术后ODI评分小于术前(P<0.05),患者术后的腰椎功能障碍得到明显改善。随访患者1年,在末次随访时经Nakai标准对疗效进行评定,总优良率为89.23%。在65例患者中,有2例术后两天右下肢麻木,且逐渐加重,可能形成血肿,给予患者开放减压术治疗,下肢麻木缓解。结论经皮椎间孔镜手术对腰椎管狭窄症进行治疗时,通过3D技术可确保能够在术前直观、精准、立体对狭窄部位和狭窄范围进行分析,可提高手术的疗效和安全性,尽可能减少并发症的发生。
Objective To investigate the feasibility and clinical effect of 3D printing in the treatment of lumbar spinal stenosis by percutaneous transpedicular endoscopy.Methods From June 2017 to December 2018,65 patients with lumbar spinal stenosis were studied.All patients were treated by percutaneous transpedicular surgery assisted by 3D printing,the treatment and outcome were summarized.Results The operation time of 65 patients was(84.23±10.52)min and the blood loss was(29.25±4.33)mL.No neurologic injury or vascular injury occurred during the operation.The postoperative VAS score was lower than that before the operation(P<0.05),and the postoperative lumbago and leg pain were relieved significantly.The ODI score after operation was lower than that before operation(P<0.05),and the postoperative lumbar dysfunction was significantly improved.The patients were followed up for 1 year,and the curative effect was evaluated by Nakai standard at the last follow-up.The total excellent and good rate was 89.23%.In 65 cases,2 cases had numbness of right lower limb two days after operation,which was gradually aggravated and might form Hematoma.The patients were treated with open decompression and the numbness of lower limb was relieved.Conclusion In the treatment of lumbar spinal stenosis by percutaneous transpedicular microsurgery,the 3D technique can be used to analyze the stenosis site and scope directly,accurately and stereoscopically before the operation,which can improve the curative effect and safety of the operation,minimize complications.
作者
朱文辉
张凯
郭高升
李赛
董晨
ZHU Wenhui;ZHANG Kai;GUO Gaosheng;LI Sai;DONG Chen(Column Surgery,Sanmenxia Central Hospital,Sanmenxia Henan 472000,China)
出处
《临床研究》
2021年第5期3-4,共2页
Clinical Research
关键词
腰椎管狭窄症
经皮椎间孔镜手术
3D打印技术
可行性
临床效果
lumbar spinal stenosis
percutaneous transpedicular microsurgery
3d printing
feasibility
clinical effect
