摘要
目的探究颈椎后路开门椎管扩大成形术中使用20°尖嘴咬骨钳或高速微型磨钻两种不同工具制作门轴对椎板开门角度的影响。方法对我院脊柱外科收治的行颈椎后路开门椎管扩大成形术的患者进行前瞻性随访,根据术中门轴制作工具的不同分为咬骨钳组和磨钻组,对所有患者术前及术后1周内拍摄颈椎计算机断层扫描(Computed Tomography,CT),分别测量术前与术后CT横断面上开门节段椎板与冠状面椎体的夹角,进行统计学分析。结果共纳入并完整随访40例患者,其中咬骨钳组23例,磨钻组17例。其中咬骨钳组术前开门节段椎板与冠状面平均夹角为(37.58±4.09)°,磨钻组为(36.19±3.92)°,无统计学差异(P=0.286),而术后咬骨钳组开门角度为(62.27±3.99)°,磨钻组为(67.17±3.48)°,具有明显差异(P<0.001)。此外,两组间患者椎板扩大角度、术前术后角度比、角度扩大率均具有统计学差异(P<0.01)。结论使用20°尖嘴咬骨钳制作门轴较之使用高速微型磨钻,可以更加精确控制开门角度,使其不至于过大,更加接近理想开门角。
Objective To investigate the effects of 20°sharp rongeur or high-speed-micro-drill on the open angle to make hinges in cervical posterior open-door expansive laminoplasty.Methods Patients who received cervical posterior open-door expansive laminoplasty were collected in our hospital and were followed up prospectively.They were divided into 2 following groups according to the instrument of making hinges,which are a 20°sharp rongeur group and a high speed micro-drill group.Cervical vertebra computed tomography(CT)was performed before operation and within 1 week after operation in all patients.The angles between the lamina and the coronal vertebral body on the CT cross-section were measured before and after surgery.Then these data were statistically analyzed.Results 40 patients were collected in and were followed up,including 23 cases in the rongeur group and 17 cases in the drill group.In the rongeur group,the mean angle between the open segment lamina and the coronal plane before operation was(37.58±4.09)°,while the angle in the drill group was(36.19±3.92)°,which showed no statistical difference between them(P=0.286).And the open angle of the rongeur group after operation was(62.27±3.99)°,while(67.17±3.48)°in drill group,which were significantly different(P<0.001).In addition,there were statistical difference in the lamina expansion angle,preoperative and postoperative open angle ratio,and expansion rate of open angle between these two groups(P<0.01).Conclusions Using 20°sharp rongeur to make hinges can control the open angle more precisely and closer to the ideal open angle than using high speed micro-drill.
作者
蔚兰哲
崔尚斌
魏富鑫
王乐
刘少喻
Yu Lanzhe;Cui Shangbin;Wei Fuxin;Wang Le;Liu Shaoyu(Department of Spine Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Orthopedic Research Institute,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Orthopedic Surgery,The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518000,China;Department of Orthopedic Surgery,Zhuhai People's Hospital(Zhuhai hospital affiliated with Jinan University),Zhuhai 519000,China)
出处
《中国临床解剖学杂志》
CSCD
北大核心
2021年第2期224-227,230,共5页
Chinese Journal of Clinical Anatomy
基金
广州市科技项目(K0221007)
广东省自然科学基金(K0213181)。
关键词
颈椎椎管扩大成形术
开门角度
尖嘴咬骨钳
高速微型磨钻
Cervical vertebra expansive laminoplasty
Open angle
Sharp rongeur
High-speed-micro-drill
