Utilization of 3D-printed surgical guide plate derived from digital orthopedic application in thoracolumbar fracture surgery and its impact on doctor-patient communication

doi:10.3760/cma.j.cn441417-20240924-07023

Abstract

Abstract:

Objective　To explore the application of 3D printing technology combined with E3D software digital design and printing thoracolumbar fracture model and personalized guide plate in the thoracolumbar fracture internal fixation and the effect on doctor-patient communication. Methods　This study was a randomized controlled trial. Fifty-one patients with thoracolumbar fracture and dislocation admitted to the General Hospital of Ningxia Medical University from February to November 2023 were selected as the study objects. The patients were divided into a control group (25 cases) and an experimental group (26 cases) by the random number table method. There were 13 males and 12 females in the control group, aged (43.27±14.36) years, vertebral body fracture site: T10 in 2 cases, T11 in 4 cases, T12 in 6 cases, L1 in 8 cases, L2 in 8 cases, and L3 in 1 case, AO fracture type: type A in 14 cases, type B in 8 cases, and type C in 3 cases, and 5 cases with other fractures. There were 13 males and 13 females in the experimental group, aged (45.32±12.31) years, vertebral body fracture site: T10 in 1 case, T11 in 2 cases, T12 in 6 cases, L1 in 12 cases, L2 in 5 cases, and L3 in 3 cases; AO fracture type: type A in 19 cases, type B in 6 cases, and type C in 1 case, and 8 cases with other fractures. The control group was treated with traditional pedicle screw fixation, and the experimental group was treated with 3D printing model and surgical guide plate. Both groups completed preoperative doctor-patient communication questionnaire survey within 24 h after admission. The doctor-patient communication [self-made questionnaire (preoperative conversation time, understanding degree on the condition and operation, and satisfaction with communication], operation situation (operation time, intraoperative blood loss, and intraoperative fluoroscopy times), and screw placement (total number of screw placement, number of screws inserted at one time, and number of screws successfully inserted into the pedicle) were compared between the two groups. Independent sample t test was used for statistical analysis. Results　The preoperative conversation time of the experimental group was shorter than that of the control group [(17.81±3.66) min vs. (20.80±3.27) min], and the understanding degree on the condition and operation and satisfaction with communication were higher than those of the control group [(8.65±0.85) points vs. (7.76±0.83) points, (8.69±1.05) points vs. (7.84±0.85) points] (all P<0.05). The operation time of the experimental group was shorter than that of the control group [(128.96±7.35) min vs. (144.08±9.03) min], and the intraoperative blood loss and fluoroscopy times were lower than those of the control group [(123.08±9.99) ml vs. (151.28±22.76) ml, (8.00±1.48) times vs. (12.28±2.41) times] (all P<0.05). There was no statistically significant difference in the total number of screws between the two groups (P>0.05); the number of screws inserted at one time and the number of screws successfully inserted into the pedicle in the experimental group were higher than those in the control group (5.58±0.86 vs. 3.76±0.97, 5.96±0.96 vs. 4.40±1.04) (both P<0.05) Conclusion　The application of 3D printing technology in spinal orthopedics can improve the effect of doctor-patient communication, shorten the operation time, reduce the intraoperative blood loss and fluoroscopy times, and improve the accuracy of screw placement.

Key words:

Thoracolumbar fracture, 3D printing, Surgical guide, Doctor-patient communication, Preoperative planning and application

摘要：

目的　探讨基于数字骨科应用的3D打印手术导板在胸腰段骨折中的手术应用及医患沟通效果。方法　本研究为随机对照试验。选取2023年2月至2023年11月宁夏医科大学总医院收治的51例胸腰段骨折脱位患者作为研究对象。采用随机数字表法，将患者分为对照组（25例）和试验组（26例）。对照组男13例，女12例；年龄（43.27±14.36）岁；骨折椎体部位：T10 2例，T11 4例，T12 6例，L1 8例，L2 8例，L3 1例；AO骨折分型：A型14例，B型8例，C型3例；伴他处骨折5例。试验组男13例，女13例；年龄（45.32±12.31）岁；骨折椎体部位：T10 1例，T11 2例，T12 6例，L1 12例，L2 5例，L3 3例；AO骨折分型：A型19例，B型6例，C型1例；伴他处骨折8例。对照组采用传统椎弓根螺钉内固定术治疗，试验组采用3D打印模型及手术导板辅助治疗。两组均在入院后24 h内完成术前医患沟通，并进行问卷调查。比较两组医患沟通情况［自制调查问卷（术前谈话时间、病情及手术情况理解程度、沟通满意程度）］、手术情况（手术时间、术中出血量、术中透视次数）、置钉情况（置钉总数量、一次性置入螺钉数、成功置入椎弓根的螺钉数量）。采用独立样本t检验进行统计学分析。结果　试验组术前谈话时间短于对照组［（17.81±3.66）min比（20.80±3.27）min］，病情及手术情况理解程度、沟通满意程度均高于对照组［（8.65±0.85）分比（7.76±0.83）分、（8.69±1.05）分比（7.84±0.85）分］（均P<0.05）。试验组手术时间短于对照组［（128.96±7.35）min比（144.08±9.03）min］，术中出血量和透视次数均少于对照组［（123.08±9.99）ml比（151.28±22.76）ml、（8.00±1.48）次比（12.28±2.41）次］（均P<0.05）。两组置钉总数量比较，差异无统计学意义（P>0.05）；试验组一次性置入螺钉数、成功置入椎弓根的螺钉数量均多于对照组［（5.58±0.86）枚比（3.76±0.97）枚、（5.96±0.96）枚比（4.40±1.04）枚］（均P<0.05）。结论　在脊柱骨科中应用3D打印技术，可改善医患沟通效果，缩短手术时间，减少术中出血量和透视次数，提高置钉准确度。

关键词:

胸腰段骨折, 3D打印, 手术导板, 医患沟通, 术前规划及应用

Ma Hui, Wu Wenjun, Zhang Zhihai, Yu Sihao, Tantai Mengxiao, Lu Zhidong.

Utilization of 3D-printed surgical guide plate derived from digital orthopedic application in thoracolumbar fracture surgery and its impact on doctor-patient communication [J]. International Medicine and Health Guidance News, 2025, 31(7): 1168-1173.

马辉吴文俊张志海俞思豪澹台梦逍陆志东.

基于数字骨科应用的3D打印手术导板在胸腰段骨折中的手术应用及医患沟通效果 [J]. 国际医药卫生导报, 2025, 31(7): 1168-1173.

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