生物骨科材料与临床研究2023，Vol.20Issue(6)：27-31,5.DOI:10.3969/j.issn.1672-5972.2023.06.005
显微镜辅助下超声骨刀在颈椎前路骨化物切除中的应用及临床疗效
Application and clinical effect of ultrasonic bone knife under microscope in anterior cervical ossification resection
摘要
Abstract
Objective To investigate the merits and demerits and clinical efficacy of ultrasonic bone knife under microscope in anterior cervical decompression compared with traditional lamina bone-biting forceps in anterior ossification of cervical spondylosis.Methods The 32 patients who underwent anterior cervical decompression and fusion in the Second Affiliated Hospital,Air Force Medical University from May 2017 to June 2019 were retrospectively analyzed.There were 18 cases in the ultrasonic bone knife group and 14 cases in the lamina bone-biting forceps decompression group.The operation time,bleeding volume,postoperative drainage volume,hospitalization days,complications,JOA score and NDI score,imaging spinal canal occupancy rate,cervical Cobb angle and fusion rate were recorded and compared between the two groups.Results Two groups of patients were successfully completed surgery,the patients in the two groups were followed up for 12-24 months,with an average of(16.18±3.33)months.One case of recurrent laryngeal nerve injury occurred in the ultrasonic bone knife group after operation,there were 2 cases of cerebrospinal fluid leakage and 2 cases of recurrent laryngeal nerve injury in the lamina bone-biting forceps decompression group,no serious complications occurred in both groups.The operation time,intraoperative blood loss and postoperative drainage volume of the ultrasonic bone knife group were less than those of the lamina bone-biting forceps decompression group(P<0.05).At the last follow-up,the NDI index of the two groups was significantly lower than that before operation(P<0.05),and the JOA score was significantly higher than that before operation(P<0.05).There was no significant difference in NDI index between the two groups at the last follow-up(P>0.05).The JOA score and the JOA improvement rate of the ultrasonic bone knife group was better than that of the lamina bone-biting forceps decompression group,and the difference was statistically significant(P<0.05).The postoperative spinal canal occupation rate of the two groups was significantly lower than that before operation(P<0.05),and the cervical Cobb angle were significantly increased before operation(P<0.05).There was no significant difference in spinal canal occupation rate between the two groups at the last follow-up(P>0.05).The cervical Cobb angle of the ultrasonic bone knife group were better than those of the lamina bone-biting forceps decompression group(P<0.05).Conclusion Microsurgical anterior cervical decompression with ultrasonic bone knife can significantly reduce bleeding,shorten operation time,reduce complications and improve functional recovery.关键词
颈椎前路间盘切除融合术/显微镜/骨化物/超声骨刀Key words
Anterior cervical discectomy and fusion/Microscope/Ossifications/Ultrasonic bone knife分类
临床医学引用本文复制引用
鲍小明,张小平,郭卫东,赵海恩,董鑫,廖博,任坤..显微镜辅助下超声骨刀在颈椎前路骨化物切除中的应用及临床疗效[J].生物骨科材料与临床研究,2023,20(6):27-31,5.基金项目
国家自然科学基金面上项目(82174166) （82174166）
陕西省创新能力支撑计划项目(2021TD-45) （2021TD-45）
空军军医大学第二附属医院临床研究重大项目(2021LCYG014) （2021LCYG014）
