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超声骨刀与传统方法在颈椎椎板切除术中的有效性和安全性:311例患者的回顾性研究

The Effectiveness and Safety of Ultrasonic Bone Scalpel Versus Conventional Method in Cervical Laminectomy: A Retrospective Study of 311 Patients.

作者信息

Dave Bharat R, Krishnan Ajay, Rai Ravi Ranjan, Degulmadi Devanand, Mayi Shivanand, Gudhe Mahendra

机构信息

Stavya Spine Hospital and Research Institute, Ahmedabad, Gujarat, India.

出版信息

Global Spine J. 2020 Sep;10(6):760-766. doi: 10.1177/2192568219876246. Epub 2019 Sep 16.

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVES

The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM).

METHOD

This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications.

RESULTS

GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB.

CONCLUSION

Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.

摘要

研究设计

回顾性队列研究。

目的

本研究旨在比较使用超声骨刀(UBS)或传统方法(CM)进行颈椎椎板切除术(CL)的结果。

方法

本研究纳入了2004年1月至2017年12月期间由同一外科医生进行的311例CL手术。A组(GpA)包括124例使用UBS进行的CL手术,而B组(GpB)包括187例使用CM进行的CL手术。比较了这两组患者的人口统计学特征、手术时间、估计失血量和手术并发症。

结果

GpA组包括112例男性和12例女性,平均年龄为61.18岁。GpB组包括166例男性和21例女性,平均年龄为62.04岁。GpA组和GpB组的平均手术时间、估计失血量和住院时间分别为65.52/70.87分钟、90.24/98.40毫升和4.80/4.87天。每组均有6例患者报告发生硬脊膜损伤。在GpA组中,观察到2例C5麻痹和1例神经根损伤,而在GpB组中,报告有3例C5麻痹且无神经根损伤。GpA组有1例患者术后出现短暂性神经功能恶化,而GpB组有11例。

结论

CM组观察到的神经并发症导致入住重症监护病房、额外的发病率和额外的费用,而UBS提供了一种安全、快速且有效的CL手术方法,从而降低了手术并发症和术后发病率。

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