Lin Qin, Lin Taotao, Wang Zhenyu, Chen Gang, Liu Wenge
Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, China.
Clin Spine Surg. 2022 Feb 1;35(1):E223-E229. doi: 10.1097/BSD.0000000000001188.
This was a retrospective study.
Our study aimed to compare the effectiveness and safety of ultrasonic bone scalpel (UBS) and high-speed drill (HSD) in modified expansive open-door laminoplasty.
The traditional methods of decompression mostly use HSD and laminectomy forceps to lift the lamina. As a new type of bone cutting instrument, UBS has the advantages of good tissue selectivity, bone cutting accuracy, good hemostasis, cold cutting, and easy operation, leading to its popular use in surgery.
Forty-two patients who underwent modified expansive open-door laminoplasty for multilevel cervical spondylotic myelopathy were included in this study. They were divided into HSD and UBS groups (n=18 and 24, respectively). Data on demographics, operation duration, blood loss, postoperative drainage, extubation time, length of stay, cost of hospitalization, and complications were collected and compared. Modified Japanese Orthopedic Association score, visual analog scale, Neck Disability Index, and axial symptoms were also recorded and analyzed.
The blood loss in the UBS group was 255.4±217.5 mL, which was lower than that in the HSD group (490.6±389.4 mL, P=0.030). The cost of hospitalization was similar between the 2 groups. The operative time and postoperative drainage did not significantly differ (P>0.05). The modified Japanese Orthopedic Association score, visual analog scale score, and Neck Disability Index score after surgery were better than those before surgery (P<0.05), but no significant difference existed between the 2 groups in each period (P>0.05). No significant difference existed in the incidence of axial symptoms and other complications (P>0.05).
The application of the UBS to modified open-door laminoplasty resulted in a safe and effective decompression effect and reduced blood loss without increasing cost benefit.
这是一项回顾性研究。
本研究旨在比较超声骨刀（UBS）和高速磨钻（HSD）在改良扩大开门式椎板成形术中的有效性和安全性。
传统的减压方法大多使用高速磨钻和椎板咬骨钳来掀起椎板。作为一种新型的骨切割器械，超声骨刀具有组织选择性好、骨切割精度高、止血效果好、冷切割以及操作简便等优点，因而在外科手术中得到广泛应用。
本研究纳入了42例行改良扩大开门式椎板成形术治疗多节段脊髓型颈椎病的患者。他们被分为高速磨钻组和超声骨刀组（分别为n = 18和24）。收集并比较了人口统计学数据、手术时间、失血量、术后引流量、拔管时间、住院时间、住院费用及并发症情况。还记录并分析了改良日本骨科协会评分、视觉模拟量表、颈部功能障碍指数及轴性症状。
超声骨刀组的失血量为255.4±217.5毫升，低于高速磨钻组（490.6±389.4毫升，P = 0.030）。两组的住院费用相似。手术时间和术后引流量无显著差异（P>0.05）。术后改良日本骨科协会评分、视觉模拟量表评分和颈部功能障碍指数评分均优于术前（P<0.05），但各时期两组间无显著差异（P>0.05）。轴性症状及其他并发症的发生率无显著差异（P>0.05）。
超声骨刀应用于改良开门式椎板成形术可产生安全有效的减压效果，减少失血量，且不增加成本效益。
