颈椎前路椎体次全切除术中应用3D打印椎体与传统钛笼重建的影像学及疗效对比研究OA

Objective To compare the imaging and clinical efficacy of 3D printed artificial vertebral body(3DP-AVB)and traditional titanium mesh cage(TMC)in anterior cervical corpectomy and fusion(ACCF)for the treatment of cervical spondylotic myelopathy(CSM).Methods A retrospective analysis was performed on 58 CSM patients who underwent single-segment ACCF in the department of spinal surgery of First Affiliated Hospital of Shandong First Medical University from March 2019 to September 2022.The patients were divided into the 3DP-AVB group(30 cases)and the TMC group(28 cases)according to different surgical implants.The general data,surgical parameters,imaging data,clinical efficacy and complications of the two groups were compared.Results All patients were followed up for an average of(13.39±0.89)months.There were no significant differences in intraoperative blood loss,operation time and postoperative hospital stay between the two groups(P>0.05).The postoperative C2-C7 Cobb angle,AVH and PVH in both groups were significantly improved compared with those before operation(P<0.05).At the last follow-up,the Cobb angle,AVH and PVH in the 3DP-AVB group were better than those in the TMC group(P<0.05).The subsidence rate in the 3DP-AVB group was significantly lower than that in the TMC group(16.67％vs 42.86％,P<0.05).The fusion rate in the 3DP-AVB group was higher than that in the TMC group(90.00％vs 78.57％),but the difference was not statistically significant(P>0.05).The postoperative JOA and NDI scores in both groups were significantly improved(P<0.05),but there were no differences in scores or improvement rates between the two groups(P>0.05).Only 1 case in the TMC group had grade B incision healing.Conclusion Both 3DP-AVB and TMC can effectively restore cervical height and curvature in ACCF,and achieve similar clinical effects.However,compared with TMC,3DP-AVB is more beneficial in reducing implant subsidence,showing a numerical trend toward a higher fusion rate and advantages in imaging stability,which is of great significance for preventing long-term complications and maintaining long-term efficacy.