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一种用于颈椎后路骨折手术的创新俯卧位:使用体型石膏床和颅骨牵引

An Innovative Prone Position Using a Body-Shape Plaster Bed and Skull Traction for Posterior Cervical Spine Fracture Surgeries.

作者信息

Ding Zhiyu, Ren Yijun, Cao Hongqing, Li Yuezhan, Chen Shijie, Miao Jinglei, Li Jinsong

机构信息

Department of Spine Surgery, The Third Xiangya Hospital, Central South University, Changsha, China.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Surg. 2022 Mar 10;9:649421. doi: 10.3389/fsurg.2022.649421. eCollection 2022.

Abstract

BACKGROUND

An innovative prone cervical spine surgical position using a body-shape plaster bed with skull traction (BSPST) was compared with the traditional prone surgical position with horseshoe headrests.

METHODS

A total of 47 patients, undergoing posterior cervical spine surgery for cervical spine fracture, were retrospectively classified into two groups, the BSPST group ( = 24) and the traditional group ( = 23), and underwent a posterior instrumented fusion with or without decompression. Multiple indicators were used to evaluate the advantages of the BSPST compared with the traditional position.

RESULTS

All the operations went smoothly. The mean recovery rate was 56.30% in the BSPST group and 48.55% in the traditional group ( = 0.454), with no significant difference. The intraoperative blood loss (177.5 ml vs. 439.1 ml, = 0.003) and the total incidence of complications (8.3 vs. 47.8%, = 0.004) were significantly less in the BSPST group than in the traditional group. In addition, the BSPST position provided a greater comfort level for the operators and allowed convenient intraoperative radiography.

CONCLUSIONS

This is the first study to describe a combined body-shape plaster bed and skull traction as an innovative cervical spine-prone surgical position that is simple, safe, and stable, intraoperative traction direction adjustable, reproducible, and economical for posterior cervical spine fracture surgery, and potentially other cervical and upper dorsal spine surgeries in the prone position. Additionally, this position provides the surgeons with a comfortable surgical field and can be easily achieved in most orthopedic operation rooms.

摘要

背景

将一种使用塑形石膏床加颅骨牵引的创新性颈椎俯卧手术体位(BSPST)与传统马蹄形头架俯卧手术体位进行比较。

方法

对47例因颈椎骨折接受颈椎后路手术的患者进行回顾性分组,分为BSPST组(n = 24)和传统组(n = 23),两组均接受了有或无减压的后路器械融合术。使用多个指标评估BSPST相对于传统体位的优势。

结果

所有手术均顺利进行。BSPST组的平均恢复率为56.30%,传统组为48.55%(P = 0.454),差异无统计学意义。BSPST组的术中出血量(177.5 ml对439.1 ml,P = 0.003)和并发症总发生率(8.3%对47.8%,P = 0.004)均显著低于传统组。此外,BSPST体位为术者提供了更高的舒适度,并便于术中进行影像学检查。

结论

本研究首次描述了一种将塑形石膏床与颅骨牵引相结合的创新性颈椎俯卧手术体位,该体位简单、安全、稳定,术中牵引方向可调节,可重复,对于颈椎后路骨折手术以及可能的其他颈椎和上胸椎俯卧位手术经济实用。此外,该体位为外科医生提供了舒适的手术视野,并且在大多数骨科手术室中都能轻松实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a71b/8960061/c14108ce6b70/fsurg-09-649421-g0001.jpg

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