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Objective To explore the application of 3D printing technology in clinical apprenticeship teaching in spinal surgery. Methods 38 eight-year clinical medical students admitted to the Department of Spine Surgery were randomly divided into experimental group (19 patients) and control group (19 patients). Taking odontoid fracture as an example. The traditional method is used for teaching, and the experimental group is taught with traditional teaching method combined with 3D printing technology . After the apprenticeship, the students of the two groups were tested in theory and simulated operation to evaluate the teaching effect. SPSS 17.0 was used for statistical analysis. The measurement data was expressed as mean ± standard deviation, and the t-test was used to compare the measurement data between two groups. Results The results showed that the scores of immediate examination and one month after class in the control group were (82.23 ±7.52) and (72.36 ±6.39) points respectively. The scores of immediate examination and one month after the class in the experimental group were (85.58 ±6.32), (80.87 ±6.23). The scores of the two examinations in the experimental group were significantly higher than those in control group , and the differences were statistically significant (P<0.05). Conclusion The 3D printing technology can significantly improve the teaching effect in the clinical apprenticeship teaching of spine surgery, and it has a bright prospect for application.
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Objective To investigate the risk factors and treatment for infections after spinal internal fixation surgery. Methods The clinical data of 472 patients who underwent spinal internal fixation surgery from January 2012 to December 2012 was analyzed retrospectively, an average age of 50. 6 years (38~78 years). All cases were underwent posterior procedures. All infected patients received emergency opera-tion of wound debridement, drainage and sensitive antibiotic treatment. The mean follow-up time was 11 months (8~19 months). Risk fac-tors and treatment for infections were summarized and discussed. Results Of 472 patients,postoperative infections occurred in 9 cases with the infection rate of 1. 91%. The operation time,intraoperative blood and postoperative drainage was 100~325 min,200~1500 mL and 65~1350 mL,respectively,which were greater than the similar surgeries of same period. The initial signs of wound infection was observed at 10 d (6~16 d) after surgery. CRP,ESR and WBC were significantly increased in 4~7 d after surgery,and maintained at high level at least for 14 d. Bacterial culture results showed infection bacteria were mainly common skin flora. One infection recurred during followed-up and subse-quent treatment was successful. Conclusion Wound infection after internal fixation mainly occurred in the posterior procedure of spine, which were deep infection. The main clinical manifestation was the wound exudate and local deep tenderness,fever and wound surface swelling were relatively rare. Increased intraoperative bleeding,postoperative drainage volume,operation time were the risk factors,which lead to perio-perative malnutrition and subsequent infections. Debridement,drainage,and intravenously sensitive antibiotics could obtain an ideal outcome for most cases. It was not necessary to remove the internal fixation instrument and bone grafting.
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Objective To evaluate the role of mangled extremity severity score(MESS)in res-ervation and amputation of crush lower limbs in earthquake. Methods There were 122 patients with crush lower limb injuries,with MESS≥8 points in 34 patients who were primarily amputated,M ESS 5-7points in 19 who were principally preserved and MESS＜5 points in 69 who were preserved by means of debridement,external fixators,plast splints and vaeuum sealing drainage technique.Results All pa-tients were survived.with amputation rate of 29.5%. Conclusion MESS is an important reference for evaluation of reservation and amputation of crush limb injuries caused by earthquake.