General Hospital of Jinan Military Commanding Region, Jinan, Shandong province, P.R. China.
Sci Rep. 2018 Mar 5;8(1):4006. doi: 10.1038/s41598-018-22454-y.
Multilevel severe compressive myelopathy is a challenging disorder for the surgeons, the aim of this study is to assess the efficacy and safety of a newly designed ultrasonic burr as an assistant tool to the ultrasonic scalpel in laminectomy for this disease. This is a retrospective comparative study, the included subjects were patients who received cervical and thoracic laminectomy using ultrasonic device (LUD, n = 9, 10 surgeries) and controls with the high-speed burr (LHB, n = 16). Fifteen patients (60.0%) showed severe cord occupancy and the average number of laminae operated was 3.5. Ultrasonic devices caused less blood loss (P = 0.02) and quicker operative time per level (P < 0.001) than LHB, and was associated with more operated laminae (P = 0.04). Preoperative JOA scores (P = 0.51), improvement rate (P = 0.47), and dural injury (P = 0.51) were not related to LUD. Our experience indicates ultrasonic devices are safe and effective for laminectomy treating multilevel and severe compressive myelopathy, the instrument could be used with ease especially for cases with ossified posterior longitudinal ligament and ossification of the ligamentum flavum, proper utility of the instrument is crucial to prevent complications.
多节段重度压迫性脊髓病对外科医生来说是一种具有挑战性的疾病，本研究旨在评估新型超声磨钻作为超声手术刀在这种疾病的椎板切除术中的辅助工具的疗效和安全性。这是一项回顾性对比研究，纳入的对象为接受超声设备（LUD，n=9，10 次手术）和高速磨钻（LHB，n=16）进行颈椎和胸椎椎板切除术的患者。15 例患者（60.0%）表现出严重的脊髓占位，平均手术椎板数为 3.5 个。与 LHB 相比，超声设备引起的出血量较少（P=0.02），每个节段的手术时间更快（P<0.001），并且与更多的手术椎板有关（P=0.04）。术前 JOA 评分（P=0.51）、改善率（P=0.47）和硬脊膜损伤（P=0.51）与 LUD 无关。我们的经验表明，超声设备在治疗多节段和重度压迫性脊髓病的椎板切除术中是安全有效的，该仪器尤其易于使用，特别是对于骨化后纵韧带和黄韧带骨化的病例，正确使用仪器对于预防并发症至关重要。
