Application effect of percutaneous vertebroplasty combined with 3D-printed personalized vertebral body stents in the repair of thoracolumbar vertebral fractures

doi:10.11958/20251037

Abstract

Abstract:

Objective To explore the application effect of vertebroplasty (PVP) combined with precise personalized vertebral stent implantation based on 3D biomechanical modeling in the repair of thoracolumbar fractures. Methods A total of 98 patients with thoracolumbar vertebral fractures treated at our hospital from September 2021 to December 2022 were selected for this study. Patients were divided into two groups based on the surgical method: the conventional group (n=50) and the combined group (n=48). The conventional group received PVP treatment, while the combined group was treated with PVP combined with 3D-printed personalized vertebral body stents. The length of incision, operation time, blood loss, drainage volume and hospital stay of the two groups were recorded. The Oswestry Disability Index (ODI) was used to assess the improvement of thoracolumbar function in patients before surgery and one month after the surgery. Cobb angle, anterior height of injured vertebra and sagittal position index were measured. Visual Analog Scale (VAS) for pain and Short Form-36 (SF-36) questionnaire for quality of life were used to evaluate low back pain, lower extremity pain and quality of life of patients before surgery and one month after surgery. Postoperative complications were also recorded. Results The length of incision, operation time, blood loss, drainage volume and hospital stay were lower in the combination group than those of the conventional group (P<0.05). ODI score and Cobb angle were lower 1 month after surgery than those before surgery in both groups, and the combined group was lower than the conventional group (P<0.05). One month after operation, the anterior height and sagittal position index of injured vertebrae were higher than those before surgery, and the combined group was higher than the conventional group (P<0.05). VAS scores were lower and SF-36 scores were higher in both groups one month after operation compared to those before the operation, with the combined group showing lower VAS scores and higher SF-36 scores compared to the conventional group (P<0.05). The total complication rate was lower in the combined group (2.08%) than that in the conventional group (16.00%, P<0.05). There was no significant difference in the overall postoperative satisfaction between the conventional group and the combined group. Conclusion The treatment of thoracolumbar fractures with PVP combined with 3D printed personalized vertebral stenting has a remarkable effect. The pain and quality of life of patients have been significantly improved, and the surgical safety is relatively good.

Key words: fractures, vertebral body, percutaneous vertebro plasty, biomechanics, 3D printing, cement leakage

CLC Number:

R274.1

Figures/Tables 6

References 24

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组别		n	年龄/岁			性别
组别		n	年龄/岁			男		女
常规组		50	52.64±4.62			28（56.0）		22（44.0）
联合组		48	53.04±4.86			30（62.5）		18（37.5）
t或χ²			0.419			0.428
组别	骨折部位
组别	T₁₁			T₁₂	L₁		L₂		L₃
常规组	8（16.0）			10（20.0）	12（24.0）		13（26.0）		7（14.0）
联合组	9（18.7）			8（16.7）	13（27.1）		10（20.8）		8（16.7）
χ²	0.739

组别		n	年龄/岁			性别
组别		n	年龄/岁			男		女
常规组		50	52.64±4.62			28（56.0）		22（44.0）
联合组		48	53.04±4.86			30（62.5）		18（37.5）
t或χ²			0.419			0.428
组别	骨折部位
组别	T₁₁			T₁₂	L₁		L₂		L₃
常规组	8（16.0）			10（20.0）	12（24.0）		13（26.0）		7（14.0）
联合组	9（18.7）			8（16.7）	13（27.1）		10（20.8）		8（16.7）
χ²	0.739

组别	n	切口长度/cm	手术时间/min
常规组	50	11.08±1.25	35.94±4.80
联合组	48	10.46±0.82	30.24±4.35
t		2.879＊	6.142＊＊
组别	术中出血量/mL	术后引流量/mL	住院时间/d
常规组	32.64±3.78	25.30±4.14	5.38±0.88
联合组	26.48±3.06	23.63±3.85	4.46±0.62
t	8.849^＊＊	2.074^＊	6.002^＊＊

组别	n	切口长度/cm	手术时间/min
常规组	50	11.08±1.25	35.94±4.80
联合组	48	10.46±0.82	30.24±4.35
t		2.879＊	6.142＊＊
组别	术中出血量/mL	术后引流量/mL	住院时间/d
常规组	32.64±3.78	25.30±4.14	5.38±0.88
联合组	26.48±3.06	23.63±3.85	4.46±0.62
t	8.849^＊＊	2.074^＊	6.002^＊＊

组别	n		ODI/分
组别	n		术前		术后1个月		t
常规组	50		60.46±9.32		18.36±2.89		28.520^＊＊
联合组	48		61.04±9.31		12.50±1.81		34.501^＊＊
t			0.309		11.969^＊＊
组别		Cobb角/°
组别		术前		术后1个月		t
常规组		17.44±2.48		7.14±0.67		27.548^＊＊
联合组		16.94±2.60		5.48±0.50		29.094^＊＊
t		0.958		13.811^＊＊
组别		伤椎前缘高度/%
组别		术前		术后1个月		t
常规组		66.48±10.21		85.27±10.08		9.086^＊＊
联合组		67.34±9.81		89.55±8.26		12.099^＊＊
t		0.425		2.288^＊
组别		矢状面指数/%
组别		术前		术后1个月		t
常规组		62.54±4.95		79.24±9.30		10.565^＊＊
联合组		62.87±6.06		83.66±9.64		14.139^＊＊
t		0.296		2.312^＊