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高速磨钻致单侧开门颈椎板成形术中椎板磨损:一项临床研究。

Lamina Abrasion Caused by High-Speed Drill in Unilateral Door Cervical Laminoplasty: A Clinical Investigation.

机构信息

Department of Orthopaedics, Xijing Hospital, The Air Force Medical University, Xi'an, Shaanxi, China (mainland).

Department of Orthopaedics, Taiyuan Satellite Launch Center Hospital, Xinzhou, Shanxi, China (mainland).

出版信息

Med Sci Monit. 2023 Jun 18;29:e939939. doi: 10.12659/MSM.939939.

Abstract

BACKGROUND The association of laminar opening extent (LOE) with sagittal canal diameter (SCD) and the cross-sectional area (CSA) in unilateral door cervical laminoplasty (UDCL) was previously analyzed. However, the lamina abrasion has been neglected, which could lead to unreliable results. The present study aims to develop the concept of effective laminar opening extent (ELOE) with consideration of the lamina abrasion and to analyze the relationships between ELOE and SCD as well as the CSA of the spinal canal. MATERIAL AND METHODS A total of 138 patients treated by UDCL were included. Pre- and postoperative SCDs and CSAs and cervical Japanese Orthopaedic Association (JOA) scores were compared to verify the effectiveness of the surgery. Linear and curvilinear regression models were used to assess the association between postoperative SCD/CSA increases and ELOE. RESULTS All surgeries were successfully performed. A total of 602 mini-plates were used, and 12-mm mini-plates was the most often used (n=402, 66.78%), while 16-mm were used the least (n=25, 4.15%). The SCDs, CSAs, and JOA scores were increased significantly after surgery (P0.939, P0.938, P.

摘要

背景

先前分析了单侧开门颈椎板成形术(UDCL)中层板开口程度(LOE)与矢状径(SCD)和横截面积(CSA)的关系。然而,层板磨损被忽略了,这可能导致结果不可靠。本研究旨在提出考虑层板磨损的有效层板开口程度(ELOE)的概念,并分析 ELOE 与 SCD 以及椎管 CSA 之间的关系。

材料与方法

共纳入 138 例行 UDCL 治疗的患者。比较术前和术后 SCD 和 CSA 以及颈椎日本矫形协会(JOA)评分,以验证手术的有效性。线性和曲线回归模型用于评估术后 SCD/CSA 增加与 ELOE 之间的关系。

结果

所有手术均成功完成。共使用了 602 块小板,最常用的是 12mm 小板(n=402,66.78%),而 16mm 小板最少(n=25,4.15%)。术后 SCD、CSA 和 JOA 评分均显著增加(P<0.001)。术后 SCD 和 CSA 增加与 ELOE 之间存在显著的线性正相关(r=0.753,P<0.001;r=0.767,P<0.001)。

结论

ELOE 可以有效预测 UDCL 术后 SCD 和 CSA 的增加,有助于术前评估和手术计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a93/10286633/57e0fb898d93/medscimonit-29-e939939-g001.jpg

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