超声骨刀与高速磨钻在峡部裂型腰椎滑脱症PLIF中的临床应用价值  

Clinical application value of ultrasonic bone knife and high-speed grinding drill in PLIF of isthmic spondylolisthesis

作　　者：田进财 马斌 海恒光 刘振 TIAN Jincai;MA Bin;HAI Hengguang;LIU Zhen(Department of Spine Surgery,Ningxia Yinchuan Guolong Orthopaedic Hospital,Yinchuan,Ningxia 750003,China)

机构地区：[1]宁夏银川国龙骨科医院脊柱外科,宁夏银川750003

出　　处：《医药前沿》2025年第7期62-65,共4页Journal of Frontiers of Medicine

摘　　要：目的 探讨超声骨刀与高速磨钻在峡部裂型腰椎滑脱症后路腰椎椎体间融合术(PLIF)中的临床应用价值。方法 选取2023年1月—2024年1月宁夏银川国龙骨科医院收治的接受PLIF治疗的50例峡部裂型腰椎滑脱症患者为研究对象,按照手术工具不同分为超声骨刀组(n=25)和高速磨钻组(n=25)。比较两组围手术期指标(手术时间、术中出血量和切口长度),治疗前和治疗3个月后脊柱-骨盆矢状面参数,治疗前和治疗15 d后疼痛程度、功能障碍、疼痛症状情况,以及并发症发生情况。结果 超声骨刀组手术时间短于高速磨钻组,术中出血量少于高速磨钻组(P<0.05)。治疗3个月后,两组矢状面平衡、颌眉角和骨盆倾斜角(PT)均短于或小于治疗前,但超声骨刀组颌眉角大于高速磨钻组,矢状面平衡和PT短于或小于高速磨钻组;两组骶骨倾斜角大于治疗前,且超声骨刀组大于高速磨钻组(P<0.05)。治疗3个月后,两组腰椎前凸角大于治疗前,腰椎后凸角小于治疗前,但两组间比较差异无统计学意义(P>0.05)。治疗15 d后,两组视觉模拟评分法和Oswestry功能障碍指数评分低于治疗前,日本骨科协会评分高于治疗前(P<0.05),但两组间比较差异无统计学意义(P>0.05)。超声骨刀组并发症总发生率低于高速磨钻组(P<0.05)。结论 超声骨刀在峡部裂型腰椎滑脱症PLIF中应用,既能缩短手术时间,减少术中出血量,减轻患者疼痛程度,还有助于提升腰椎及脊柱功能,且安全性较好。Objective To explore the clinical application value of ultrasonic bone knife and high-speed grinding drill in posterior lumbar interbody fusion(PLIF)for isthmic spondylolisthesis.Methods From January 2023 to January 2024,a total of 50 patients with isthmic spondylolisthesis who received PLIF treatment in Ningxia Yinchuan Guolong Orthopaedic Hospital were selected as the research objects.According to different surgical tools,they were divided into ultrasonic bone knife group(n=25)and high-speed grinding group(n=25).The perioperative indexes(operation time,intraoperative blood loss and incision length),spinal-pelvic sagittal parameters before treatment and 3 months after treatment,pain degree,dysfunction and pain symptoms before treatment and 15 days after treatment,and complications were compared between the two groups.Results The operation time of the ultrasonic bone knife group was shorter than that of the high-speed grinding group,and the intraoperative blood loss was less than that of the high-speed grinding group(P<0.05).After 3 months of treatment,the sagittal balance,jaw-brow angle and pelvic tilt(PT)of the two groups were shorter or less than those before treatment,but the jaw-brow angle of the ultrasonic osteotome group was larger than those of the high-speed drill group,and the sagittal balance and PT were shorter or less than that of the high-speed drill group.The sacrum slope of the two groups was greater than that before treatment,and that of the ultrasonic bone knife group was greater than that of the high-speed grinding group(P<0.05).After 3 months of treatment,the lumbar lordosis angle of the two groups was larger than that before treatment,and the lumbar kyphosis angle was smaller than that before treatment,but there was no significant difference between the two groups(P>0.05).After 15 days of treatment,the Visual Analogue Scale and Oswestry Disability Index score of the two groups were lower than those before treatment,and the Japanese Orthopaedic Association scores was higher than that before tr

关 键 词：超声骨刀 高速磨钻 腰椎滑脱症 后路腰椎椎体间融合术 腰椎后凸角 骶骨倾斜角 

分 类 号：R681[医药卫生—骨科学]