Department of Orthopedics Surgery, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengu, Sichuan, Tibet.
Department of Orthopedics Surgery, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengu, Sichuan, Tibet; Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
World Neurosurg. 2022 Jun;162:e484-e491. doi: 10.1016/j.wneu.2022.03.039. Epub 2022 Mar 16.
To investigate the application skills and importance of ultrasonic bone osteotome in anterior cervical discectomy and fusion surgery.
Between January 2018 and December 2020, the data of 97 patients who underwent anterior cervical disc resection and fusion (ACDF) in our hospital were collected and retrospectively analyzed. According to the main instruments for decompression of the intervertebral space, we divided the 97 patients into ultrasonic bone osteotome (UBS) group and traditional high-speed drill (HSD) group. The intraoperative indexes selected for comparison between the 2 groups were intervertebral space decompression time, intraoperative blood loss, incidence and types of complications within the 2 groups of patients, Japanese Orthopedic Association (JOA) scores, and JOA improvement rates of the 2 groups of patients before and after surgery.
There was no statistical difference in general data such as age, sex, duration of symptoms, and surgical segment between the 2 groups (P > 0.05). Intervertebral decompression time, intraoperative blood loss, and complications in the UBS group were less than those in the HSD group (P < 0.05). The JOA scores of the 2 groups of patients were significantly improved after the operation compared with scores from before the operation, with results being statistically significant (P < 0.05), however, there was no difference in clinical effect between the 2 groups at each follow-up time point (P > 0.05).
This study shows that in ACDF surgery, UBS is more efficient than HSD and can effectively shorten the operation time and reduce the amount of bleeding and the incidence of complications.
探讨超声骨刀在前路颈椎间盘切除融合术中的应用技巧及重要性。
回顾性分析 2018 年 1 月至 2020 年 12 月我院收治的 97 例行前路颈椎间盘切除融合术(ACDF)患者的临床资料。根据术中椎间隙减压的主要器械将患者分为超声骨刀(UBS)组和传统高速磨钻(HSD)组,比较两组患者的术中指标(包括椎间隙减压时间、术中出血量、两组患者并发症的发生率和类型)、两组患者术前和术后日本矫形外科学会(JOA)评分、两组患者术后 JOA 评分改善率。
两组患者的一般资料(年龄、性别、症状持续时间、手术节段)比较,差异无统计学意义(P > 0.05)。UBS 组的椎间隙减压时间、术中出血量及并发症发生率均少于 HSD 组(P < 0.05)。两组患者术后 JOA 评分均较术前明显提高,差异有统计学意义(P < 0.05),但两组患者在各个随访时间点的临床疗效比较,差异无统计学意义(P > 0.05)。
在 ACDF 手术中,UBS 比 HSD 更有效,可有效缩短手术时间,减少出血量,降低并发症发生率。