超声骨刀辅助截骨椎板回植微型钛板内固定治疗椎管内肿瘤临床观察  

Clinical effect of internal fixation of micro-titanium plate with ultrasonic osteotome-assisted osteotomy and vertebral plate replantation in treatment of intraspinal tumor

作　　者：石海龙[1] 殷铁林[1] 张华[1] 王祥善[1] SHI Hailong;YIN Tielin;ZHANG Hua;WANG Xiangshan(Department of Spinal Surgery,Zhengzhou Orthopaedics Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院脊柱外科,河南郑州450052

出　　处：《肿瘤基础与临床》2024年第2期151-153,共3页journal of basic and clinical oncology

摘　　要：目的探讨超声骨刀辅助椎板回植微型钛板内固定治疗椎管内肿瘤的早期临床疗效与安全性。方法回顾性分析2018年5月至2023年5月郑州市骨科医院收治的56例椎管内肿瘤患者的临床资料,其中采用超声骨刀行椎板截骨、瘤体切除棘突椎板回植微型钛板内固定29例(超声骨刀组)、采用传统椎板切除、瘤体切除、椎弓根螺钉内固定27例(传统组)。比较2组手术时间、术中出血量、术后引流量、住院时间、日本骨科协会(JOA)评分、JOA改善率、并发症。结果超声骨刀组患者手术时间、术中出血量、术后引流量及住院时间均短于传统组(t=2.546,P=0.031;t=11.342,P=0.018;t=4.675,P=0.021;t=3.256,P=0.024)。超声骨刀组和对照组术后1周患者JOA评分均高于同组术前(t=308.336,P=0.002;t=132.568,P=0.004)。超声骨刀组患者JOA改善率(60.75±15.46)%,传统组为(58.97±15.97)%(t=0.946,P=0.403)。2组患者均未出现明显并发症。结论超声骨刀辅助截骨椎板回植微型钛板内固定治疗椎管内肿瘤的临床疗效和安全性优于传统的椎板切除内固定。Objective To evaluate the early clinical effect and safety of internal fixation of micro-titanium plate with ultrasonic osteotome-assisted osteotomy and vertebral plate replantation in the treatment of intraspinal tumors.Methods The clinical data of fifty-six patients with intraspinal tumors hospitalized in Zhengzhou Orthopedic Hospital from May 2018 to May 2023 were retrospectively collected and analyzed.All the patients were treated with microscopically assisted resection of intraspinal tumors,they were divided into two groups:the ultrasonic scalpel group(29 patients)and the traditional group(27 patients).The operation time,bleeding volume,postoperative drainage volume,hospital stay,Japanese Orthopaedic Association(JOA)scores,improvement rate of JOA and perioperative complications of the two groups were recorded and compared.Results There was significant difference in operation time,bleeding volume,postoperative drainage volume and hospital stay(t=2.546,P=0.031;t=11.342,P=0.018;t=4.675,P=0.021;t=3.256,P=0.024).The JOA score of one week after operation was significantly better than that before operation(t=308.336,P=0.002;t=132.568,P=0.004),but there was no significant difference in the improvement rate of JOA between the two groups(t=0.946,P=0.403).There were no serious complications in both groups.Conclusion Internal fixation of micro-titanium plate with ultrasonic osteotome-assisted osteotomy and vertebral plate replantation can play a safe and effective role in the treatment of intraspinal tumors,which is superior to traditional pedicle screw internal fixation surgery.

关 键 词：椎管内肿瘤 椎板回植 超声骨刀 

分 类 号：R739.42[医药卫生—肿瘤]