The Application Of 3D Priinting Technology In The Surgery Of Lumbar Spondylolisthesis

ObjectivesThe objective was to evaluate the effectiveness of 3D printing technology in the surgery of lumbar spondylolisthesis MethodsPatients with recurrent lumbar spondylolisthesis who were preparing to undergo lumbar surgery from Qian fo Shan hospital of Shandong province between Apirl 2015 and July 2016 were included in this analysis.Patients were divided into two groups.In 3D printing group,3D printing technology was used to create subject-specific lumbar vertebral models in the preoperative planning process.The control group underwent lumbar surgery as usual.Data from patients who underwent Lumbar Interbody fusion and Internal fixation by a single senior doctor in our hospital.There was no difference between groups for sex?age?Duration of symptom(months)?Oswestry Disability Index(ODI)?Japan Orthopaedics Association(JOA)scores?and visual analogue scale(VAS)scores for back pain and leg pain before the operation.Postoperative clinical outcomes were compared between groups included operation time,Postoperative Drainage Volume,the accuracy rate of the pedicle screw placement,Fluoroscopy times,perioperative blood loss,postoperative complications,Oswestry Disability Index(ODI)?Japan Orthopaedics Association(JOA)scores,and visual analogue scale(VAS)scores for back pain and leg pain in a week postoperative.Computed tom-ography(CT)scan is used to determine the accuracy of lumbar pedicle screw placement?Then Statistical analysis was conducted.ResultsA total of 39 patients were included in this study(3D printing Group=19,Control Group=20).Two Groups had a significantly difference in operation time(124.7±13.2 vs 148.0±9.7min,P<0.05)? significantly less blood loss(341.6± 51.6ml vs 380.5±58.6ml,P<0.05)?Fluoroscopy times(4.4±0.76vs5.4± 1.47)?the accuracy rate during operation of the pedicle screw placement(94.7% vs 88.7%)?Postoperative Drainage Volume(215.8±28.5 vs 238.8± 25.7ml)and The mean time of pedicle screw implanted(21.4±2.8vs 31.6± 6.2 min).There was no difference between groups for complication rate?complications,Oswes try Disability Index(ODI),Japan Orthopaedics Association(JOA)scores,and visual analogue scale(VAS)scores for back pain and leg pain in a week postoperative,There were also no differences between groups for any clinical metric.Computed tomography(CT)scan is used to determine the accuracy of lumbar pedicle screw placement?And showed that the excellent rate of pedicle screw position was higher in 3D printing group than that in control group(96.1% vs 86.2%)ConclusionUsing the 3D printing technology before Lumbar Interbody fusion and Internal fixation of lumbar spondylolisthesis may improve surgical safety,and reduce the operation time and the perioperative blood loss.There does not appear to be a benefit to using the technology with respect to clinical outcomes.Future prospective studies are needed to further elucidate the efficacy of this emerging technology.