摘要
目的探讨在颈后路全椎板切除减压手术中,应用超声骨刀进行截骨操作的优势。方法回顾性分析2013-05-2017-05行颈后路全椎板切除减压手术的61例患者,其中29例术中采用超声骨刀进行椎板切除,作为观察组;另32例则采用高速磨钻,作为对照组。对两组患者的单节段椎板切除时间、单节段手术出血量,以及术后1周的颈椎JOA评分改善情况进行对比。结果观察组患者的单节段椎板切除时间及手术出血量均显著少于对照组,差异有统计学意义(P<0.05);与术前相比,观察组术后1周的平均JOA改善率达到(51.3±17.6)%,对照组为(53.2±15.8)%,两组差异无统计学意义(P>0.05)。对照组1例术中发生硬膜撕裂,观察组无一例发生硬膜撕裂、脊髓神经损伤等事件。结论在颈后路全椎板切除减压手术中应用超声骨刀进行截骨操作,手术时间短、出血量少,且安全可靠,有较好的临床应用价值。
Objective To discuss the advantages of osteotomy with ultrasonic bone knife duringthe decompression of the posterior cervical laminectomy. Methods A retrospective analysis wasperformed in 61 patients who underwent posterior laminectomy and decompression surgery from May2013 to May 2017. Of them,29 cases underwent laminectomy with ultrasonic scalpel were selected asthe observation group, while the other 32 cases treated with high-speed drill were selected as controlgroup. The single segment lamina resection time, single segment operation bleeding, and the cervicalJOA score at 1 week after operation were compared between the two groups. Results The singlesegment laminectomy time and bleeding volume in the observation group were significantly less thanthose in the control group, the differences were statistically significant （P〈0.05）. Compared with beforeoperation, the average JOA improvement rate in the observation group at 1 week after operation was（51.3±17.6）%, that in the control group was （53.2±15.8）%. There was no significant difference betweenthe two groups （P〉0.05）. In the control group, there was 1 case of dura tearing in the operation. Therewas no case of epidural tear and spinal nerve injury in the observation group. Conclusion In theposterior cervical laminectomy, the operation of osteotomy with ultrasonic scalpel has shorter operativetime and less bleeding. It is safe and reliable, and has good clinical application value.
作者
曹云
徐剑峰
卿培东
崔立强
CAO Yun;XU Jian-feng;QING Pei-dong;CUI Li-qiang(Mianyang Orthopaedic Hospital,Mianyang,Sichuan,621000,China.)
出处
《颈腰痛杂志》
2018年第6期768-770,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
后路全椎板切除减压手术
超声骨刀
后纵韧带骨化症
颈椎管狭窄
高速磨钻
posterior total laminectomy and decompression
ultrasonic osteosurgery
ossificationof posterior longitudinal ligament
cervical spinal stenosis
high speed drill.
