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Objective To explore the application of 3D printing technology in surgical approach choice for cervical vertebra dumbbell tumor.Methods Retrospectively analyzed the clinical data of 17 patients with cervical vertebra dumbbell tumor who were admitted into our hospital from August 2012 and February 2017 and recieved 3D model printing.Three director surgeons chosen surgical approach for each pa-tient with or without 3D printing models.The surgical approach,combined with 3D printing and chosen by most surgeons,was selected as final surgical approach for patients.All the patients were evaluated by JOA score and Frankel grade before and after operation.Results The tumor of patients who selected surgical approach with 3D printing was completely resected.Without 3D printing models in preoperation,3 surgeons selected the same surgical approach for 8 patients,2 surgeons selected the same surgical approach for 9 patients.Compared with those who se-lected surgical approach with 3D printing models in preoperation,the 3 surgeons changed surgical approach in a total of 13 times.The surgical approach of 5 patients were changed,including 2 cases changed from posterior approach to lateral approach,2 cases changed from lateral ap-proach to posterior approach,and 1 case changed from lateral approach to anterior approach.Eventually,11 cases underwent posterior ap-proach,1 case underwent anterior approach,3 cases underwent lateral approach and 2 cases underwent far lateral approach.Conclusion Ap-plied of 3D printing in treatment of cervical vertebra dumbbell tumor can rebuild and print local anatomy by digitizing method.It can excel-lently show the tumor form,relationship of tumor and vertebrae,tumor and foramen intervertebrale,tumor and vessel.3D printing technology could help surgeon precisely and directly understand the operation area and select advanced surgical approach to reduce surgical risk and in -crease the resection rate of tumor.And it has an excellent display effect especially for complex tumors and abnormal blood vessels.
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<p><b>OBJECTIVE</b>Combining K-line (the connecting line of the midpoint of C₂ and C₇ spinal canal on the cervical lateral X-ray film) to analyze the relationship between cervical range of motion of patients with ossification of posterior longitudinal ligament (OPLL) and surgical prognosis.</p><p><b>METHODS</b>A total 42 patients with ossification of cervical posterior longitudinal ligament underwent cervical posterior single open-door laminoplasty between April 2014 and March 2017 were retrospectively ananyzed. The patients were dividing into K-line (+) group and K-line (-) group according to the position realationship of OPLL and K-line. The lesion of ossification of the posterior longitudinal ligament was not over than the K-line known as K-line (+). Conversely, the lesion of ossification of the posterior longitudinal ligament crossing the K-line was called K-line (-). Preoperative and postoperative 3 months JOA scores were observed, and postoperative 3 months JOA improvement rate were computed to assess patient's neurological function recovery. Preoperation and postoperative 3 months, OPLL occupation ratio (OOR), cervical lordotic angles (CLA) and cervical lordotic value (CLV) were measured respectively. The realationship between postoperative neurologic functional recovery in patients of CLV>0 group and CLV<=0 group was evaluated in different K-line subgroups.</p><p><b>RESULTS</b>For the patients in K (+) group and K (-) group, preoperative CLA were (14.7±9.6)° and (-6.4±9.5)°(<0.05) respectively, postoperative at 3 months CLA were (14.0±8.0)° and (-1.4±10.4)°(<0.05) respectively; preoperative JOA scores were 10.9±3.2 and 11.2±2.5 (>0.05) respectively, postoperative at 3 months JOA scores were 14.2±1.8 and 12.6±2.2 (<0.05) respectively, and postoperative at 3 months JOA score improvement rate were (54.7±17.6)% and (25.5±15.7)%(<0.05) respectively. In the K-line (+) group, there were 29 patients in CLV>0 group at 3 months after operation, with improvement rate of (52.3±17.2)%, and 4 patients in CLV<=0 group, with improvement rate of (72.2±7.8)%. The improvement rate of the patients in CLV<=0 group was significantly better than that of the patients in CLV>0 group (<0.05).</p><p><b>CONCLUSIONS</b>No matter whether the ossification of cervical posterior longitudinal ligament was classified as K-line (+) or K-line (-), the cervical posterior single open-door laminoplasty can improve the neurological symptoms of patients, especially the patients in the K-line(+) group with better prognosis. The patinets in K-line(+) group, when postoperative at 3 months CLV>0, their improvement rate was lower than that of the patients with postoperative at 3 months CLV<=0.</p>
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Objective To explore the effect of spinal 360°circumferential resection decompression combined with bone cement fill-separation and pedicle screw fixation instrumentationb for patients suffering from spinal metastases.Methods Retrospectively analyzed the clinical data of 42 patients suffering from spinal metastases and underwent spinal 360°circumferential resection decompression combine with bone cement fill-separation and pedicle screw fixation instrumentation in our hospital from April 2012 to October 2016.The pain level were assessed by visual analogue scale(VAS),the functional impairment was classified by Karnofsky score(KPS) and the neurologic deficit was evaluated by Frankel grade before preoperation,1 week after operation and 3 months after operation.Results Through the following-up of 3 months,there was no neural symptoms relapse in primary segment.The VAS score was (0.57 ±0.79) points,and the KPS was (72.61 ± 19.12) points 3 months after operation,which were significantly improved compared with the data before operation (P ＜ 0.05).The VAS score improvement rate was (91.09％ ±13.73％),and the Frankel grade improvement rate was 80％.Conclusion Circumferential resection decompression combined with bone cement fill-separation and pedicle screw fixation instrumentationb for patients suffering from spinal metastases can effectively improve the neural symptoms and life-quality of patients and prevent neural symptoms relapsing in primary segment after operation.