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[1]郭亮兵,潘玉林,郭小偉,等.超聲骨刀截骨和高速磨鉆截骨行頸后路單開門椎管擴大成形微型鈦板內(nèi)固定治療多節(jié)段脊髓型頸椎病的對比研究[J].中醫(yī)正骨,2021,33(08):23-27.
　GUO Liangbing,PAN Yulin,GUO Xiaowei,et al.A comparison of piezosurgery and high-speed grinding drill for osteotomy in unilateral open-door laminoplasty and miniature titanium plates internal fixation...[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(08):23-27.
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超聲骨刀截骨和高速磨鉆截骨行頸后路單開門椎管擴大成形微型鈦板內(nèi)固定治療多節(jié)段脊髓型頸椎病的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年08期
頁碼:
23-27
欄目:
臨床研究
出版日期:
2021-08-20

文章信息/Info

Title:
A comparison of piezosurgery and high-speed grinding drill for osteotomy in unilateral open-door laminoplasty and miniature titanium plates internal fixation...
作者:
郭亮兵; 潘玉林; 郭小偉; 李寶田; 張猛; 焦云龍; 張懷栓; 楊廣輝; 劉曉曦
(鄭州市骨科醫(yī)院,河南 鄭州 450052)
Author(s):
GUO Liangbing; PAN Yulin; GUO Xiaowei; LI Baotian; ZHANG Meng; JIAO Yunlong; ZHANG Huaishuan; YANG Guanghui; LIU Xiaoxi
Zhengzhou Orthopedics Hospital,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
頸椎病;  椎板成形術(shù);  超聲骨刀;  高速磨鉆;  臨床試驗
Keywords:
cervical spondylosis;  laminoplasty;  piezosurgery;  high speed grinding drill;  clinical trial
文獻標(biāo)志碼:
A
摘要:
目的:比較超聲骨刀截骨和高速磨鉆截骨行頸后路單開門椎管擴大成形微型鈦板內(nèi)固定治療多節(jié)段脊髓型頸椎病的早期臨床療效與安全性。方法:回顧性分析46例多節(jié)段脊髓型頸椎病患者的病例資料,均采用頸后路單開門椎管擴大成形微型鈦板內(nèi)固定治療,術(shù)中采用超聲骨刀截骨24例(超聲骨刀截骨組)、采用高速磨鉆截骨22例(高速磨鉆截骨組)。比較2組患者手術(shù)時間、術(shù)中出血量、術(shù)后引流量、并發(fā)癥發(fā)生情況、術(shù)后1周日本骨科學(xué)會(Japanese Orthopaedic Association,JOA)脊髓型頸椎病評分及JOA脊髓型頸椎病評分改善率。結(jié)果:①一般指標(biāo)。2組患者手術(shù)時間和術(shù)中出血量比較,組間差異無統(tǒng)計學(xué)意義[(141.21±19.33)min,(158.42±28.10)min,t=1.543,P=0.101;(180.00±56.26)mL,(204.55±60.92)mL,t=1.412,P=0.162]; 超聲骨刀截骨組術(shù)后引流量少于高速磨鉆截骨組[(155.43±73.06)mL,(224.37±84.11)mL,t=2.209,P=0.039]。②JOA脊髓型頸椎病評分。術(shù)前及術(shù)后1周,2組患者JOA脊髓型頸椎病評分比較,組間差異均無統(tǒng)計學(xué)意義[(9.3±3.1)分,(9.1±3.4)分,t=1.024,P=0.313;(14.5±1.2)分,(14.3±1.4)分,t=0.113,P=0.901]; 術(shù)后1周,2組患者JOA脊髓型頸椎病評分均高于術(shù)前(t=320.327,P=0.002; t=128.604,P=0.005)。③JOA脊髓型頸椎病評分改善率。術(shù)后1周,2組患者JOA脊髓型頸椎病評分改善率比較,差異無統(tǒng)計學(xué)意義[(63.12±16.32)%,(61.44±17.17)%,t=0.733,P=0.421]。④安全性。2組均未發(fā)生神經(jīng)損傷、腦脊液滲漏等并發(fā)癥。結(jié)論:采用超聲骨刀截骨和高速磨鉆截骨行頸后路單開門椎管擴大成形微型鈦板內(nèi)固定治療多節(jié)段脊髓型頸椎病,手術(shù)時間、術(shù)中出血量、早期臨床療效和安全性相當(dāng),但前者術(shù)后引流量少。
Abstract:
Objective:To compare the early clinical curative effects and safety of piezosurgery versus high-speed grinding drill for osteotomy in unilateral open-door laminoplasty and miniature titanium plates internal fixation through cervical posterior approach for treatment of multisegment cervical spondylotic myelopathy(CSM).Methods:The medical records of 46 patients with multisegment CSM were analyzed retrospectively.All patients were treated with unilateral open-door laminoplasty and miniature titanium plates internal fixation through cervical posterior approach,and the piezosurgery and high-speed grinding drill were used for osteotomy during the surgery in 24 patients(piezosurgery group)and 22 patients(high-speed grinding drill group)respectively.The operative time,intraoperative blood loss,postoperative drainage volume,complications,Japanese Orthopaedic Association(JOA)CSM scores and improvement rate of JOA CSM scores measured at 1 week after the surgery were compared between the 2 groups.Results:There was no statistical difference in operative time and intraoperative blood loss between the 2 groups(141.21±19.33 vs 158.42±28.10 minutes,t=1.543,P=0.101; 180.00±56.26 vs 204.55±60.92 mL,t=1.412,P=0.162).The postoperative drainage volume was less in piezosurgery group compared to high-speed grinding drill group(155.43±73.06 vs 224.37±84.11 mL,t=2.209,P=0.039).There was no statistical difference in JOA CSM scores between the 2 groups before the surgery and at 1 week after the surgery(9.3±3.1 vs 9.1±3.4 points,t=1.024,P=0.313; 14.5±1.2 vs 14.3±1.4 points,t=0.113,P=0.901).The JOA CSM scores increased in the 2 groups at 1 week after the surgery compared to pre-surgery(t=320.327,P=0.002; t=128.604,P=0.005).There was no statistical difference in improvement rate of JOA CSM scores between the 2 groups at 1 week after the surgery(63.12±16.32 vs 61.44±17.17%,t=0.733,P=0.421).No complications such as nerve injuries and cerebrospinal fluid leakage were found in the 2 groups.Conclusion:Osteotomy using piezosurgery is similar to osteotomy using high-speed grinding drill in operative time,intraoperative blood loss,early clinical curative effects and safety in unilateral open-door laminoplasty and miniature titanium plates internal fixation through cervical posterior approach for treatment of multisegment CSM,while the former has less postoperative drainage volume compared to the latter.

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更新日期/Last Update: 2022-03-23