超声骨刀在颈椎椎板(C_(3～7))单开门椎管扩大成形术中的应用  

Application of piezosurgery in cervical vertebra open-door expansive laminoplasty(C_(3-7))

作　　者：王齐超[1] 王海蛟[1] 何兵[1] 张永辉[1] 

机构地区：[1]漯河市中心医院关节脊柱科,河南462003

出　　处：《中国骨与关节损伤杂志》2016年第11期1121-1123,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的分析超声骨刀在颈椎椎板(C_(3～7))单开门椎管扩大成形术中的实用性及临床效果。方法纳入自2015-06—2016-01经影像学诊断证实的36例脊髓型颈椎病,行颈椎椎板(C_(3～7))单开门椎管扩大成形术治疗。随机分为试验组和对照组,各18例。试验组术中使用超声骨刀,对照组术中使用微型磨钻。比较2组手术时间、术中出血量、术中每分钟出血量、术后1周JOA评分、术后JOA评分改善率、术后48 h引流量。结果与对照组相比,试验组手术时间更短,术中出血量、术中每分钟出血量更少,差异有统计学意义(P<0.05)。2组术后1周JOA评分、术后JOA评分改善率、术后48 h引流量差异无统计学意义(P>0.05)。结论在颈椎椎板(C_(3～7))单开门椎管扩大成形术中,与使用微型磨钻相比,使用超声骨刀手术时间更短,术中出血量更少,对骨组织及软组织损伤更小,更为安全、高效、精准、可靠。Objective To evaluate the reliability and clinical effect of piezosurgery in cervical vertebra open-door expansive laminoplasty （C3-7）. Methods A total of 36 cervical spondylotic myelopathy patients who needed open-door expansive laminoplasty were selected in this study, 18 patients were randomized to each group. These patients were diagnosed by radiographic and physical examination from June 2015 to January 2016. The operative time, bleeding volume in operation, bleeding volume per minute, JOA score before operation, JOA score in one week after operation, the postoperative improvement rate（JOA）, postoperative drainage（48 h） were compared between piezosurgery（experimental group） and micro- grinding drill（control group） in laminoplasty. Results The experimental group was better than control group in operative time, bleeding volume in operation and bleeding volume per minute（P 〈0.05）, and no significant differences were found in JOA score before operation, JOA score in one week after operation, the postoperative period（JOA）, post-operation（48 h） drainage between two groups （P 〉0.05）. Conclusion The piezosurgery is of shorter operative time, less blood loss, less injury of bone and soft tissue in laminoplasty, and it is safer, more efficient, more accurate and more reliable in cervical vertebra opendoor expansive laminoplasty（C3-7）.

关 键 词：脊髓型颈椎病 超声骨刀 微型磨钻 椎管扩大成形术 JOA评分 

分 类 号：R687.3[医药卫生—骨科学]