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导航式可扩张椎体笼与传统可扩张椎体笼在微创腰椎/胸腰椎椎体切除术中的比较。

Comparison of Navigated Expandable Vertebral Cage with Conventional Expandable Vertebral Cage for Minimally Invasive Lumbar/Thoracolumbar Corpectomy.

机构信息

Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan.

Department of Orthopaedic Surgery, Kobe Red Cross Hospital, Kobe 651-0073, Japan.

出版信息

Medicina (Kaunas). 2022 Mar 1;58(3):364. doi: 10.3390/medicina58030364.

Abstract

: The thoracolumbar burst fracture is one of the most common spinal injuries. If the patient has severe symptoms, corpectomy is indicated. Currently, minimally invasive corpectomy with a navigated expandable vertebral cage is available thanks to spinal surgical technology. The aim of this study is to retrospectively compare clinical and radiographic outcomes of conventional and navigational minimally invasive corpectomy techniques. : We retrospectively evaluated 21 patients who underwent thoracolumbar minimally invasive corpectomy between October 2016 and January 2021. Eleven patients had a navigated expandable cage (group N) and 10 patients had a conventional expandable cage (group C). Mean follow-up period was 31.9 months for group N and 34.7 months for group C, ranging from 12 to 42 months in both groups. Clinical and radiographic outcomes are assessed using values including visual analogue scale (VAS) for back pain and Oswestry disability index (ODI). This data was collected preoperatively and at 6, 12, and 24 months postoperatively. : Surgical time and intraoperative blood loss of both groups were not significantly different (234 min vs. 267 min, 656 mL vs. 786 mL). Changes in VAS and ODI were similar in both groups. However, lateral cage mal-position ratio in group N was lower than that of group C (relative risk 1.64, Odds ratio 4.5) and postoperative cage sinking was significantly lower in group N ( = 0.033). : Clinical outcomes are not significantly different, but radiographic outcomes of lateral cage mal-position and postoperative cage sinking were significantly lower in the navigation group.

摘要

胸腰椎爆裂性骨折是最常见的脊柱损伤之一。如果患者症状严重,需要进行椎体切除术。目前,得益于脊柱外科技术,可采用导航可扩张椎体笼进行微创椎体切除术。本研究旨在回顾性比较传统和导航微创椎体切除术技术的临床和影像学结果。

我们回顾性评估了 2016 年 10 月至 2021 年 1 月期间接受胸腰椎微创椎体切除术的 21 例患者。11 例患者采用导航可扩张 cage(N 组),10 例患者采用传统可扩张 cage(C 组)。N 组的平均随访时间为 31.9 个月,C 组为 34.7 个月,两组均为 12 至 42 个月。采用视觉模拟评分(VAS)评估背痛和 Oswestry 功能障碍指数(ODI)评估临床和影像学结果。这些数据在术前和术后 6、12 和 24 个月收集。

两组的手术时间和术中出血量无显著差异(234 分钟比 267 分钟,656 毫升比 786 毫升)。两组 VAS 和 ODI 的变化相似。然而,N 组的侧方 cage 位置不当比率低于 C 组(相对风险 1.64,优势比 4.5),N 组术后 cage 下沉明显低于 C 组(=0.033)。

临床结果无显著差异,但导航组的侧方 cage 位置不当和术后 cage 下沉的影像学结果明显更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47df/8952499/7a4ef5b9e965/medicina-58-00364-g001.jpg

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