Xu Chen, Wang Zhaodong, Liu Yajun, Zhu Zhonglian, Duan Keyou, Wu Min, Guan Jianzhong
Department of Orthopedics, Anhui Province Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Aug 15;37(8):996-1001. doi: 10.7507/1002-1892.202302024.
To investigate the effect of ultrasonic bone curette in anterior cervical spine surgery.
A clinical data of 63 patients with cervical spondylosis who were admitted between September 2019 and June 2021 and met the selection criteria was retrospectively analyzed. Among them, 32 cases were operated with conventional instruments (group A) and 31 cases with ultrasonic bone curette (group B). There was no significant difference between the two groups (>0.05) in gender, age, surgical procedure, surgical segment and number of occupied cervical space, disease type and duration, comorbidities, and preoperative Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (NDI), and pain visual analogue scale (VAS) score. The operation time, intraoperative bleeding, postoperative drainage, postoperative hospital stay, and the occurrence of postoperative complications were recorded in both groups. Before operation and at 1, 3, and 6 months after operation, the JOA score and NDI were used to evaluate the function and the postoperative JOA improvement rate was calculated, and VAS score was used to evaluate the pain improvement. The anteroposterior and lateral cervical X-ray films were taken at 1, 3, and 6 months after operation to observe whether there was any significant loosening and displacement of internal fixators.
Compared with group A, group B had shorter operation time and postoperative hospital stay, less intraoperative bleeding and postoperative drainage, and the differences were significant (<0.05). All incisions healed by first intention in the two groups, and postoperative complications occurred in 5 cases (15.6%) in group A and 2 cases (6.5%) in group B, showing no significant difference (>0.05). All patients were followed up 6-12 months (mean, 7.9 months). The JOA score and improvement rate gradually increased in groups A and B after operation, while the VAS score and NDI gradually decreased. There was no significant difference in VAS score between 3 months and 1 month in group B (>0.05), and there were significant differences between the other time points of each indicator in the two groups (<0.05). At 1, 3, and 6 months after operation, the JOA score and improvement rate in group B were better than those in group A (<0.05). X-ray films examination showed that there was no screw loosening or titanium plate displacement in the two groups after operation, and the intervertebral cage or titanium mesh significantly sank.
Compared with traditional instruments, the use of ultrasonic bone curette assisted osteotomy in anterior cervical spine surgery has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and shorter hospital stay.
探讨超声骨刀在前路颈椎手术中的应用效果。
回顾性分析2019年9月至2021年6月收治的63例符合入选标准的颈椎病患者的临床资料。其中32例采用传统器械手术（A组），31例采用超声骨刀手术（B组）。两组在性别、年龄、手术方式、手术节段及颈椎占位间隙数量、疾病类型及病程、合并症、术前日本骨科协会（JOA）评分、颈椎功能障碍指数（NDI）及疼痛视觉模拟量表（VAS）评分等方面比较，差异无统计学意义（>0.05）。记录两组手术时间、术中出血量、术后引流量、术后住院时间及术后并发症发生情况。术前及术后1、3、6个月采用JOA评分及NDI评估功能并计算术后JOA改善率，采用VAS评分评估疼痛改善情况。术后1、3、6个月行颈椎正侧位X线片检查，观察内固定物有无明显松动及移位。
与A组比较，B组手术时间及术后住院时间短，术中出血量及术后引流量少，差异有统计学意义（<0.05）。两组切口均甲级愈合，A组术后并发症发生5例（15.6%），B组2例（6.5%），差异无统计学意义（>0.05）。所有患者均获随访6～12个月（平均7.9个月）。术后两组JOA评分及改善率逐渐升高，VAS评分及NDI逐渐降低。B组术后3个月与1个月VAS评分比较，差异无统计学意义（>0.05），两组各指标其余时间点比较，差异有统计学意义（<0.05）。术后1、3、6个月，B组JOA评分及改善率均优于A组（<0.05）。X线片检查示两组术后均无螺钉松动及钛板移位，椎间融合器或钛网无明显下沉。
与传统器械相比，超声骨刀辅助截骨在前路颈椎手术中具有手术时间短、术中出血少、术后引流量少及住院时间短等优点。
