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已发表论文
3D 打印结合术中 CT 引导下经皮椎体成形术（PVP）治疗胸腰椎骨质疏松性骨折的安全性和准确性
Authors Yu X, Zhou Z, Zhang W, Liu Z, Wang B, Li T, Chang H, Deng J, Wang X, Zhang Z, Liu Z
Received 29 April 2025
Accepted for publication 18 September 2025
Published 29 October 2025 Volume 2025:18 Pages 6975—6983
DOI https://doi.org/10.2147/JMDH.S537567
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Xiaoming Yu,1 Zhenghang Zhou,2 Wei Zhang,3 Zelong Liu,4 Bin Wang,4 Tong Li,4 Hua Chang,4 Jing Deng,4 Xu Wang,5 Zhentao Zhang,4 Zhaohua Liu6
1Graduate School, Hebei North University, Zhangjiakou, 075000, People’s Republic of China; 2Department of Emergency, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 3Department of Orthopedics, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 4Department of Pain Management, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 5Department of Information Science, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 6Department of Nursing, Langfang Health Vocational College, Langfang, 065000, People’s Republic of China
Correspondence: Zhentao Zhang, Department of Pain Management, Langfang People’s Hospital, No. 37 of Xinhua Road Langfang, Langfang, 065000, People’s Republic of China, Tel +86 0316 2369520, Fax +86 0316 2369690, Email zhang_zhentao@yeah.net Zhaohua Liu, Department of Nursing, Langfang Health Vocational College, Siguang Road South Langfang, Langfang, 065000, People’s Republic of China, Tel +86 0316 2369520, Fax +86 0316 2369690, Email liu_zhaohua@21cn.com
Objective: This study assesses the safety and precision of percutaneous vertebroplasty (PVP) for thoracolumbar osteoporotic fractures using 3D printing and intraoperative CT guidance.
Methods: This retrospective cohort study included 100 patients with thoracolumbar osteoporotic fractures who underwent PVP from January 2020 to December 2022. Preoperative CT scans were used to create 3D printed models for surgical planning and simulation. Intraoperative CT was employed post-needle insertion and pre-cement injection for accuracy verification. Outcomes were measured using the visual analog scale (VAS) for pain, Oswestry disability index (ODI) for functionality, and assessments of vertebral height and kyphotic angle. Complications recorded included cement leakage, nerve injury, and adjacent vertebral fracture. Subgroup analysis was performed to compare outcomes between thoracolumbar and lumbar fractures.
Results: Average operation time was 35.6 ± 8.4 minutes, and fluoroscopy time was 12.3 ± 3.7 seconds. Intraoperative CT confirmed precise needle placement, with no occurrences of cement leakage or nerve injury. VAS scores improved from 8.2 ± 1.5 preoperatively to 2.1 ± 0.9 postoperatively, and ODI scores from 72.3 ± 9.8% to 18.4 ± 6.7%. Subgroup analysis showed no significant differences in clinical or radiographic outcomes between thoracolumbar and lumbar groups, although a higher cement volume was used in lumbar vertebrae (3.6 vs 2.8 mL, p< 0.001). There was significant post-surgical restoration and maintenance of vertebral height and kyphotic angle, with no adjacent vertebral fractures reported.
Conclusion: PVP using 3D printing and intraoperative CT for thoracolumbar osteoporotic vertebral fractures is safe, accurate, and effective in pain relief, functional improvement, and vertebral morphology restoration. The 3D models enhance surgical planning, while intraoperative CT provides real-time feedback for needle and cement placement.
Keywords: percutaneous vertebroplasty, 3D printing, intraoperative CT guidance, osteoporotic vertebral fractures
1Graduate School, Hebei North University, Zhangjiakou, 075000, People’s Republic of China; 2Department of Emergency, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 3Department of Orthopedics, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 4Department of Pain Management, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 5Department of Information Science, Langfang People’s Hospital, Langfang, 065000, People’s Republic of China; 6Department of Nursing, Langfang Health Vocational College, Langfang, 065000, People’s Republic of China
Correspondence: Zhentao Zhang, Department of Pain Management, Langfang People’s Hospital, No. 37 of Xinhua Road Langfang, Langfang, 065000, People’s Republic of China, Tel +86 0316 2369520, Fax +86 0316 2369690, Email zhang_zhentao@yeah.net Zhaohua Liu, Department of Nursing, Langfang Health Vocational College, Siguang Road South Langfang, Langfang, 065000, People’s Republic of China, Tel +86 0316 2369520, Fax +86 0316 2369690, Email liu_zhaohua@21cn.com
Objective: This study assesses the safety and precision of percutaneous vertebroplasty (PVP) for thoracolumbar osteoporotic fractures using 3D printing and intraoperative CT guidance.
Methods: This retrospective cohort study included 100 patients with thoracolumbar osteoporotic fractures who underwent PVP from January 2020 to December 2022. Preoperative CT scans were used to create 3D printed models for surgical planning and simulation. Intraoperative CT was employed post-needle insertion and pre-cement injection for accuracy verification. Outcomes were measured using the visual analog scale (VAS) for pain, Oswestry disability index (ODI) for functionality, and assessments of vertebral height and kyphotic angle. Complications recorded included cement leakage, nerve injury, and adjacent vertebral fracture. Subgroup analysis was performed to compare outcomes between thoracolumbar and lumbar fractures.
Results: Average operation time was 35.6 ± 8.4 minutes, and fluoroscopy time was 12.3 ± 3.7 seconds. Intraoperative CT confirmed precise needle placement, with no occurrences of cement leakage or nerve injury. VAS scores improved from 8.2 ± 1.5 preoperatively to 2.1 ± 0.9 postoperatively, and ODI scores from 72.3 ± 9.8% to 18.4 ± 6.7%. Subgroup analysis showed no significant differences in clinical or radiographic outcomes between thoracolumbar and lumbar groups, although a higher cement volume was used in lumbar vertebrae (3.6 vs 2.8 mL, p< 0.001). There was significant post-surgical restoration and maintenance of vertebral height and kyphotic angle, with no adjacent vertebral fractures reported.
Conclusion: PVP using 3D printing and intraoperative CT for thoracolumbar osteoporotic vertebral fractures is safe, accurate, and effective in pain relief, functional improvement, and vertebral morphology restoration. The 3D models enhance surgical planning, while intraoperative CT provides real-time feedback for needle and cement placement.
Keywords: percutaneous vertebroplasty, 3D printing, intraoperative CT guidance, osteoporotic vertebral fractures