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| Clinical effect of individualized 3D printing model assisted posterior fixation in the treatment of atlantoaxial instability |
| LIN Jun-hua ZHAO Shan-ming ZHANG Jian-rong CHEN Jin-ming LI Xiao-xiong |
| Department of Orthopaedics,Xinhui District People′s Hospital of Jiangmen City in Guangdong Province,Jiangmen 529100,China |
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Abstract Objective To analyze the clinical effect of individualized 3D printing model assisted posterior fixation in the treatment of atlantoaxial instability.Methods From January 2017 to December 2018,20 patients with atlantoaxial instability treated in our hospital were selected as the subjects,and divided into control group and study group by random number table method,with 10 cases in each group.The patients in the control group were treated with internal fixation with bare hands according to experience,and patients in the study group were treated with 3D printing technology to establish an individualized 3D printing model of cervical spine.Analog nailing and internal fixation were used before operation.Fixation was processed to obtain individualized data of nail placement,which provided assistance for real operation.One-stage posterior decompression and internal fixation were performed on patients.The operation time,bleeding volume,and pain score,Japanese Orthopaedic Association (JOA) score,atlas odontoid space,medulla oblongata cervical spinal cord angle before and after operation were compared between the two groups.Results The operation time of the study group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).The amount of bleeding in the study group was less than that in the control group,and the difference was statistically significant (P＜0.05).After operation,the pain score in the study group was lower than that before operation,JOA score was higher than that before operation,atlas odontoid space was smaller than that before operation,and medulla oblongata cervical spinal angle was lager than that before operation,the differences were statistically significant (P＜0.05).There was no significant difference in pain score and JOA score of the control group before and after operation (P＞0.05).In the control group,the atlanto odontoid space after operation was smaller than that before operation,and the medulla oblongata angle was lager than that before operation,the differences were statistically significant (P＜0.05).There were no significant differences in preoperative pain score,JOA score,atlanto odontoid space and medullary angle between the two groups (P＞0.05).After operation,the pain score in the study group was lower than that in the control group,the JOA score was higher than that in the control group,the atlas odontoid space was smaller than that in the control group,and medulla oblongata cervical spinal angle was lager than that in the control group,the differences were statistically significant (P＜0.05).Conclusion For patients suffering from atlantoaxial instability,applying individualized 3D print model to assist the posterior fixation can improve the success rate of screw setting,protect nerve root and vertebral artery with favorable safety.The treatment effect of using individualized 3D print model to assist the posterior fixation is significant for patients suffering from congenital vertebral malformation and high-riding vertebral artery.
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