3D打印低温热塑板体表定位在椎间孔入路脊柱内镜下手术治疗骨化性腰椎间盘突出症中的应用

Application of 3D-printed low-temperature thermoplastic splint body surface positioning in spinal endoscopic operation via foraminal approach in treating ossified lumbar intervertebral disc protrusion

中文关键词:  全可视化脊柱内镜  低温热塑板  3D打印  椎间孔入路  骨化性腰椎间盘突出症

英文关键词:Fully visualized spinal endoscopy  Low-temperature thermoplastic board  3D printing  Intervertebral foramen approach  Ossified lumbar intervertebral disc protrusion.

中文摘要:

  【摘要】 目的：探讨经椎间孔入路脊柱内镜手术治疗骨化性腰椎间盘突出症中3D打印塑板体表定位技术的临床应用价值。方法：纳入2022年1月~2024年10月于我科就诊的37例骨化性腰椎间盘突出症手术患者为研究对象，其中男性15例，女性22例，年龄14~74岁（52.3±11.6岁）；根据有无采用辅助定位方案将其分为对照组（全可视化脊柱内镜手术，19例）和观察组（3D打印塑板体表定位联合手术，18例），两组患者的性别、年龄、手术节段、身体质量指数（body mass index，BMI）等无统计学差异（P＞0.05）。比较两组手术时间、术中透视次数、椎管横截面积变化及术前、术后5d腰痛视觉模拟量表（visual analogue scale，VAS）评分、Oswestry功能障碍指数（Oswestry disability index，ODI）。结果：相较于对照组，观察组手术时间显著减少（63.1±2.6min vs 73.8±4.4min，P＜0.05）；透视次数显著减少[1.00（1.00，2.00） vs 5.00（4.00，5.00），P＜0.05]，术后5d的腰痛VAS评分显著降低[1.00（1.00，1.25）分 vs 3.00（2.00，3.00）分，P＜0.05]，椎管横截面积改善及术后5d的ODI无统计学差异（P＞0.05）。结论：椎间孔入路脊柱内镜手术治疗骨化性腰椎间盘突出症中应用3D打印塑板体表定位技术可显著减少透视次数及手术时间，提高椎间孔入路脊柱内镜手术效率，对缓解腰腿痛症状具有优势。

英文摘要:

  【Abstract】 Objectives: To explore the clinical application value of 3D-printed plastic plate surface positioning technique in the treatment of ossified lumbar intervertebral disc herniation with spinal endoscopic surgery through intervertebral foramen approach. Methods: A total of 37 patients with ossified lumbar intervertebral disc herniation who underwent surgery from January 2022 to October 2024 were included as the study subjects, including 15 males and 22 females, aged 14 to 74 years, with an average age of 52.3±11.6 years. They were randomly divided into a control group(full visualization spinal endoscopic surgery, 19 cases) and an observation group(3D-printed plastic plate surface positioning combined with surgery, 18 cases) depending on whether an auxiliary positioning scheme was adopted or not. There were no statistically significant differences in gender, age, surgical segments, and body mass index(BMI) between the two groups(P>0.05). The operative time, intraoperative fluoroscopy times, changes in the cross-sectional area of the spinal canal, and visual analogue scale(VAS) scores for low back pain and Oswestry disability index(ODI) before and 5d after surgery were compared between the two groups. Results: Compared with the control group, the observation group had significantly shorter operative time(63.1±2.6min vs 73.8±4.4min, P<0.05), fewer fluoroscopy times[1.00(1.00, 2.00) vs 5.00(4.00, 5.00), P<0.05], and lower VAS scores at 5d post-operation[1.00(1.00, 1.25) vs 3.00(2.00, 3.00), P<0.05]. There was no statistically significant difference in the improvement of spinal canal cross-sectional area and postoperative 5d ODI(P>0.05). Conclusions: 3D-printed low temperature thermoplastic splint surface positioning can significantly reduce the number of fluoroscopy times and operative time, improve the efficiency of intervertebral foramen approach spinal endoscopic surgery, which has the advantages in alleviating the symptoms of low back and leg pain.