摘要
目的探讨超声骨刀在颈椎前路手术中的应用效果。方法回顾分析2019年9月—2021年6月收治且符合选择标准的63例颈椎病患者临床资料。其中32例颈椎前路手术中采用常规器械操作(A组),31例采用超声骨刀(B组)。两组患者性别、年龄、手术方式、手术节段及累及椎间隙数量、疾病类型及病程、合并症以及术前日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI)、疼痛视觉模拟评分(VAS)等基线资料比较,差异均无统计学意义(P>0.05)。记录两组手术时间、术中出血量、术后引流量、术后住院时间,以及术后并发症发生情况。术前及术后1、3、6个月,采用JOA评分及NDI评价功能并计算术后JOA改善率,VAS评分评价疼痛改善情况。术后1、3、6个月摄颈椎正侧位X线片,观察内固定物有无松动、下沉。结果与A组相比,B组手术时间及术后住院时间缩短,术中出血量及术后引流量减少,差异均有统计学意义(P<0.05)。术后两组切口均Ⅰ期愈合,A组5例(15.6%)、B组2例(6.5%)发生并发症,并发症发生率差异无统计学意义(P>0.05)。两组患者均获随访,随访时间6~12个月,平均7.9个月。术后两组JOA评分及改善率均逐渐升高、VAS评分及NDI逐渐降低,除B组术后3个月VAS评分与1个月差异无统计学意义(P>0.05)外,两组各指标其余时间点间比较差异均有统计学意义(P<0.05)。术后1、3、6个月B组JOA评分及改善率均优于A组,差异有统计学意义(P<0.05)。X线片复查示两组术后均无螺钉松动、钛板移位,椎间融合器或钛网明显下沉发生。结论与应用常规器械相比,颈椎前路手术中采用超声骨刀辅助截骨具有手术时间短、术中出血量少、术后引流量少及住院时间短的优势。
Objective To investigate the effect of ultrasonic bone curette in anterior cervical spine surgery.Methods A clinical data of 63 patients with cervical spondylosis who were admitted between September 2019 and June 2021 and met the selection criteria was retrospectively analyzed.Among them,32 cases were operated with conventional instruments(group A)and 31 cases with ultrasonic bone curette(group B).There was no significant difference between the two groups(P>0.05)in gender,age,surgical procedure,surgical segment and number of occupied cervical space,disease type and duration,comorbidities,and preoperative Japanese Orthopaedic Association(JOA)score,cervical dysfunction index(NDI),and pain visual analogue scale(VAS)score.The operation time,intraoperative bleeding,postoperative drainage,postoperative hospital stay,and the occurrence of postoperative complications were recorded in both groups.Before operation and at 1,3,and 6 months after operation,the JOA score and NDI were used to evaluate the function and the postoperative JOA improvement rate was calculated,and VAS score was used to evaluate the pain improvement.The anteroposterior and lateral cervical X-ray films were taken at 1,3,and 6 months after operation to observe whether there was any significant loosening and displacement of internal fixators.Results Compared with group A,group B had shorter operation time and postoperative hospital stay,less intraoperative bleeding and postoperative drainage,and the differences were significant(P<0.05).All incisions healed by first intention in the two groups,and postoperative complications occurred in 5 cases(15.6%)in group A and 2 cases(6.5%)in group B,showing no significant difference(P>0.05).All patients were followed up 6-12 months(mean,7.9 months).The JOA score and improvement rate gradually increased in groups A and B after operation,while the VAS score and NDI gradually decreased.There was no significant difference in VAS score between 3 months and 1 month in group B(P>0.05),and there were significant differences
作者
徐陈
王照东
刘亚军
朱仲廉
段克友
吴敏
官建中
XU Chen;WANG Zhaodong;LIU Yajun;ZHU Zhonglian;DUAN Keyou;WU Min;GUAN Jianzhong(Department of Orthopedics,Anhui Province Key Laboratory of Tissue Transplantation,the First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui,233000,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2023年第8期996-1001,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
2022年度蚌埠医学院厅级重点实验室开放课题(AHTT2022B002)
安徽省教育厅科学研究重点项目(2022AH051493)。
关键词
超声骨刀
颈椎病
颈椎前路手术
Ultrasonic bone curette
cervical spondylosis
anterior cervical spine surgery
