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压电手术治疗脊柱背侧。

Piezoelectric Surgery for Dorsal Spine.

机构信息

Department of Neurosurgery, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy.

Department of Neurosurgery, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy.

出版信息

World Neurosurg. 2018 Jun;114:58-62. doi: 10.1016/j.wneu.2018.03.026. Epub 2018 Mar 10.

DOI:10.1016/j.wneu.2018.03.026
PMID:29530686
Abstract

BACKGROUND

Laminoplasty and laminectomy are 2 common surgical procedures used in treating degenerative and neoplastic diseases of the spinal canal. Routinely used instruments, such as the Kerrison rongeur and high-speed drill, can result in potentially serious complications, such as dural injury and thermal and mechanical damage to neurovascular structures. We adopted piezoelectric bone surgery, which permits a selective cut of mineralized tissues, to perform posterior procedures on the thoracic spine, where the relationship between bone and the spinal cord is critical. The aim of this article was to evaluate the use of piezoelectric surgery for performing dorsal spine laminectomy and laminoplasty.

METHODS

The Mectron piezosurgery device was developed for cutting bone with microvibrations that are created by the piezoelectric effect. This instrument allows a safe and precise bone cut, and it is characterized by no heat generation, thus avoiding thermal injury to bone and soft tissues. We used this device to perform 8 laminoplasties for tumors of the dorsal spine and 2 laminectomies for thoracic spinal stenosis in 10 patients.

RESULTS

There were no procedure-related intraoperative complications, such as dural injury or damage to neural structures.

CONCLUSIONS

The piezoelectric device showed excellent results in terms of safety and precise bone cutting properties when performing posterior surgical procedures in the dorsal spine, where thermal injury produced by the conventionally used drill may damage the spinal cord closer to bony elements.

摘要

背景

椎管狭窄症的退行性和肿瘤性疾病的治疗中,椎板切开术和椎板切除术是两种常用的手术方法。常规使用的器械,如 Kerrison 咬骨钳和高速钻头,可能会导致严重的并发症,如硬脑膜损伤以及对神经血管结构的热损伤和机械损伤。我们采用了可以选择性切割矿化组织的压电骨手术,在胸椎等对骨骼和脊髓关系要求较高的部位进行后路手术。本文旨在评估压电手术在胸椎后路椎板切除术和椎板成形术中的应用。

方法

Mectron 压电骨手术系统是通过压电效应产生微振动来切割骨骼的。该器械可安全、精确地切割骨骼,其特点是不产生热,从而避免对骨骼和软组织的热损伤。我们使用该设备为 10 例胸椎肿瘤患者实施了 8 例椎板成形术和 2 例胸椎椎管狭窄症椎板切除术。

结果

无手术相关的术中并发症,如硬脑膜损伤或神经结构损伤。

结论

在胸椎后路手术中,压电设备在安全性和精确的骨切割方面表现出色,而传统钻头产生的热损伤可能会对靠近骨组织的脊髓造成损伤。

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