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一种新型高速屏蔽弧形钻头的使用与颈椎椎体切除融合术后术中及临床结果的改善相关:一项回顾性病例系列研究。

The use of a new high-speed shielded curved drill is associated with improved intraoperative and clinical outcomes after cervical corpectomy and fusion procedures: a retrospective case series.

机构信息

Center for Spine Care, 17980 Dallas Pkwy Ste 300, Dallas, TX, 75287, USA.

Scripps Clinic Torrey Pines, 10666 N Torrey Pines Rd., La Jolla, CA, 92037, USA.

出版信息

J Orthop Surg Res. 2023 May 17;18(1):364. doi: 10.1186/s13018-023-03769-7.

Abstract

BACKGROUND

Anterior cervical corpectomy and fusion (ACCF) is an effective technique to address multi-level degenerative cervical myelopathy. However, as the number of surgical levels increases, the outcomes worsen with respect to complication rates, range of motion and length of surgery. This study aimed to determine the clinical outcome of ACCF procedures performed using a new distally curved and shielded drilling device.

METHODS

A retrospective study was conducted on 43 ACCF procedures in which the device was used for osteophyte removal. Patient files were reviewed to assess the early clinical results and complications following ACCF. Clinical outcomes were evaluated using patient neck and arm pain scores and SF-36 questionnaires. Hospitalization characteristics were compared with historical controls.

RESULTS

All procedures were uneventful and without major complications or neurological deterioration. Single-level ACCF procedures required an average of 71 min and followed by an average hospitalization of 3.3 days. Osteophyte removal, verified by intraoperative imaging, was satisfactory. Average neck pain score was improved by 0.9 points (p = 0.24). Average arm pain score was improved by 1.8 points (p = 0.06). SF-36 scores were improved in all domains.

CONCLUSIONS

The new curved device enabled safe and efficient removal of osteophytes sparing adjacent vertebral removal in ACCF procedures, thus improving the clinical outcome.

摘要

背景

颈椎前路椎体次全切除融合术(ACCF)是治疗多节段退行性颈椎病的有效方法。然而,随着手术节段的增加,并发症发生率、活动范围和手术时间都会对手术结果产生不利影响。本研究旨在评估一种新型远端弯曲且带保护套的钻孔设备在 ACCF 手术中的临床效果。

方法

回顾性分析了 43 例行 ACCF 手术的患者资料,术中使用该设备切除骨赘。评估 ACCF 后患者的早期临床结果和并发症。通过患者颈部和手臂疼痛评分以及 SF-36 问卷评估临床疗效。比较住院时间和特征与历史对照。

结果

所有手术均顺利完成,无重大并发症或神经恶化。单节段 ACCF 手术平均耗时 71 分钟,平均住院时间为 3.3 天。术中影像学证实骨赘切除满意。平均颈部疼痛评分改善 0.9 分(p=0.24),平均手臂疼痛评分改善 1.8 分(p=0.06)。SF-36 各维度评分均有改善。

结论

新型弯曲装置可安全有效地切除骨赘,同时保留相邻椎体,从而改善 ACCF 手术的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e502/10189983/61952e47fab7/13018_2023_3769_Fig1_HTML.jpg

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