背景:腰椎前凸分布已成为重建腰椎基本排列的关键因素。这可以直接影响整体矢状对齐,改善患者的长期预后。尽管广泛存在旨在实现术后最佳对齐的高张力储备笼,笼的脊柱前凸形状与由此产生的椎间对齐之间缺乏相关性。最近,个性化脊柱手术见证了重大进步,包括3D打印的个性化椎体间植入物,这是根据外科医生的治疗和对齐目标定制的。这项研究评估了3D打印的患者特异性椎间植入物的可靠性,以实现计划的术后椎间对齐。
方法:这是一项对217例脊柱畸形或退行性疾病患者的回顾性研究。如果患者接受3D打印的个性化椎间植入物,则将其包括在内。为每个个性化椎间前凸(IVL)目标(IVL目标)在设备设计中规定了所需的椎间前凸(IVL)角度。测量术后站立的X光片,IVL偏移计算为IVL达到减去IVL目标。
结果:在该患者人群中,365个个性化的身体被植入,包括145个腰椎前路椎间融合术(ALIF),99外侧腰椎椎体间融合(LLIF),和121个经椎间孔腰椎椎间融合术。在365个治疗水平中,IVL偏移为1.1°±4.4°(平均值±SD)。IVL在299个水平(81.9%)的计划5°内实现。IVL偏移取决于腰椎椎间融合术的方法,对于LLIF的85.9%,在5°内实现。82.6%的经椎间孔腰椎椎间融合术和78.6%的ALIF。十个级别(2.7%)错过了计划的IVL>10°。错过计划超过5°的ALIF和LLIF水平往往被过度校正。
结论:本研究支持使用3D打印的个性化椎间植入物来实现计划的矢状椎间对齐。
结论:个性化椎间植入物可持续实现IVL目标,并可能影响基础腰椎对准。
方法:
BACKGROUND: Lumbar lordosis distribution has become a pivotal factor in re-establishing the foundational alignment of the lumbar spine. This can directly influence overall sagittal alignment, leading to improved long-term outcomes for patients. Despite the wide availability of hyperlordotic stock cages intended to achieve optimal postoperative alignment, there is a lack of correlation between the lordotic shape of a cage and the resultant intervertebral alignment. Recently, personalized spine surgery has witnessed significant advancements, including 3D-printed personalized interbody implants, which are customized to the surgeon\'s treatment and alignment goals. This study evaluates the reliability of 3D-printed patient-specific interbody implants to achieve the planned postoperative intervertebral alignment.
METHODS: This is a retrospective study of 217 patients with spinal deformity or degenerative conditions. Patients were included if they received 3D-printed personalized interbody implants. The desired intervertebral lordosis (IVL) angle was prescribed into the device design for each personalized interbody (IVL goal). Standing postoperative radiographs were measured, and the IVL offset was calculated as IVL achieved minus IVL goal.
RESULTS: In this patient population, 365 personalized interbodies were implanted, including 145 anterior lumbar interbody fusions (ALIFs), 99 lateral lumbar interbody fusions (LLIFs), and 121 transforaminal lumbar interbody fusions. Among the 365 treated levels, IVL offset was 1.1° ± 4.4° (mean ± SD). IVL was achieved within 5° of the plan in 299 levels (81.9%). IVL offset depended on the approach of the lumbar interbody fusion and was achieved within 5° for 85.9% of LLIF, 82.6% of transforaminal lumbar interbody fusions and 78.6% of ALIFs. Ten levels (2.7%) missed the planned IVL by >10°. ALIF and LLIF levels in which the plan was missed by more than 5° tended to be overcorrected.
CONCLUSIONS: This study supports the use of 3D-printed personalized interbody implants to achieve planned sagittal intervertebral alignment.
CONCLUSIONS: Personalized interbody implants can consistently achieve IVL goals and potentially impact foundational lumbar alignment.
METHODS: