超声骨刀在颈椎后路单开门术中的应用  

Comparing the Application of Ultrasonic Bone Curette in Posterior Cervical Single Open-Door Laminoplasty

作　　者：郑羽晨 张睿[1] 陈晓生 蓝涛[1] 郭伟壮[1] 杨欣建[1] 李伟[1] ZHENG Yu-chen;ZHANG Rui;CHEN Xiao-sheng;LAN Tao;GUO Wei-zhuang;YANG Xin-jian;LI Wei(The Second People＇s Hospital of Shenzhen,The First Affiliated Hospital of Shenzhen University,Guangdong Shenzhen 518035)

机构地区：[1]深圳市第二人民医院深圳大学第一附属医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2018年第20期80-83,199,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:比较超声骨刀和高速磨钻在颈椎后路单开门椎管扩大成形术中的安全性与有效性。方法:对2014年7月至2018年2月深圳市第二人民医院收治的87例行颈椎后路单开门椎管扩大成形术患者的临床资料进行分析。其中应用高速磨钻47例为A组,超声骨刀40例为B组。比较两组手术时间、术中出血量、术后引流量、术前及术后1周日本骨科协会(JOA)脊髓功能评分、JOA评分改善率、围手术期并发症等指标。结果:两组患者的年龄、性别、病程、减压节段、术前JOA评分比较,差异均无统计学意义(P> 0.05);A组和B组术中出血量比较,差异无统计学意义(P> 0.05);B组手术时间明显少于A组,差异具有统计学意义(P<0.05);B组术后引流量明显少于A组,差异具有统计学意义(P <0.05)。两组患者术后JOA评分均优于术前,但两组间术前、术后JOA评分及JOA改善率比较,差异均无统计学意义(P> 0.05)。两组术后各出现1例脂肪液化,均未出现硬脊膜撕裂,脊髓及神经损伤、C5神经根麻痹等并发症。结论:超声骨刀和高速磨钻均能安全有效的完成颈椎后路单开门椎管扩大成形术,同时获得良好的临床效果。超声骨刀在减轻术者工作强度,缩短手术时间和减少术后引流上更具有优势。Objective To compare the safety and effectiveness of posteroir cervical single open-door laminoplasty using ultrasonic bone currette Versus high-speed drill. Methods From July 2014 to February 2018, 87 patients with cervical spondylotic myelopathy underwent posterior cervical single open-door laminoplasty by either using ultrasonic bone currette（n = 40） or highspeed drill（n = 47）. The data were collected and analyzed retrospectively. The operation time, blood loss, postoperative drainage, JOA scores, rate of the improved JOA score and incidence of complications were compared between ultrasonic bone currette and highspeed drill groups. Results There were no signifi cant differences in age, gender, duration of disease, decompression segment, and preoperative JOA score between the two groups（P〈0.05）. There was no signifi cant difference in the amount of intraoperative blood loss between group A and group B（P〈0.05）. The operation time of group A was signifi cantly longer than that of group B, and the difference was statistically signifi cant（P〈0.05）. The drainage volume in group A was signifi cantly higher than that in group B, and the difference was statistically signifi cant（P〈0.05）. The postoperative JOA scores of the two groups were better than those before surgery, but there was no signifi cant difference between the two groups before and after surgery（JOA score and JOA improvement rate）（P〈0.05）. There was 1 case of fat liquefaction in the two groups, and there were no complications such as dural tear, spinal cord and nerve injury, and C5 nerve root palsy. Conclusion Compared with high-speed drill, usage of ultrasonic bone currette is more effi cient but similarly safe to perform posterior cervical single open-door laminoplasty.

关 键 词：脊髓型颈椎 椎管扩大成形术 超声骨刀 

分 类 号：R687.3[医药卫生—骨科学]