[1]陈卓 杨易 远刘泽祥 屈若木 吴云霞 姜亮**.超声骨刮匙在C7穹隆减压手术中的应用[J].中国微创外科杂志,2022,01(12):934-938.
　Chen Zhuo,Yang Yiyuan,Liu Zexiang,et al.Application of Ultrasonic Bone Curette in C7 Dome Decompression During Cervical Laminoplasty[J].Chinese Journal of Minimally Invasive Surgery,2022,01(12):934-938.
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超声骨刮匙在C7穹隆减压手术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年12期
页码:
934-938
栏目:
临床研究
出版日期:
2023-03-13

文章信息/Info

Title:
Application of Ultrasonic Bone Curette in C7 Dome Decompression During Cervical Laminoplasty
作者:
陈卓 杨易 远刘泽祥 屈若木 吴云霞 姜亮**
(北京大学第三医院骨科，北京100191)
Author(s):
Chen Zhuo;  Yang Yiyuan;  Liu Zexiang;  et al.
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China
关键词:
C7穹隆减压术; 超声骨刮匙; 椎板成形术; 脊髓型颈椎病
Keywords:
C7 dome decompression; Ultrasound bone curette; Laminoplasty; Cervical spondylotic myelopathy
文献标志码:
A
摘要:
目的探讨颈椎椎板成形术中应用超声骨刮匙(ultrasonic bone curette，UBC)进行C7穹窿减压的安全性和有效性。方法2019年9月~2020年6月我科应用UBC行C4~6椎板成形、C3椎板切除、C7穹隆减压椎板成形术，观察患者手术前后日本骨科学会（Japanese Orthopedic Association,JOA)评分、生活质量量表（Short Form 36,SF36）评分、颈椎功能障碍指数(Neck Disability Index，NDI)评分及影像学表现。结果手术时间(115.0±29.9)min(77~182 min)，术中出血量50~300 ml(中位数150 ml)。术后住院时间平均5.1 d(3~9 d)。术后均未发生脑脊液漏、神经损伤和出血。40例随访平均18.6月(12~21个月)，末次随访JOA评分从术前(12.0±2.4)分提高到(14.9±1.8)分(t=-20.597,P=0.000)。SF36评分从术前(23.2±5.0)分提高到(26.5±3.8)分(t=-13.344,P=0.000)；NDI评分从术前中位数13.5(2~34)分降低到3.5(0~30)分(Z=-5.521,P=0.000);C2~7 Cobb角由术前13.6°±5.7°下降到12.0°±5.8°(t=6.467,P=0.000)；C2~7颈椎活动度从术前37.0°±91°下降到31.0°±6.6°(t=13.244,P=0.000)；C7棘突到椎体的最小径线从术前(9.2±2.2)mm提高到(12.8±1.9)mm(t=-39.622,P=0.000)。结论颈后路C7椎板穹隆减压术中应用UBC安全、有效。
Abstract:
ObjectiveTo investigate the safety and efficacy of a specialized ultrasound bone curette (UBC) in C7 dome decompression during cervical laminoplasty.MethodsClinical data of 40 patients who underwent C46 laminoplasty, C3 laminectomy, and C7 dome decompression with the use of a UBC from September 2019 to June 2020 were retrospectively analyzed. Patients’ Japanese Orthopedic Association (JOA) score, Short Form 36 (SF36) general life status score, neck disability index (NDI) score, and radiographic data were extracted and analyzed.ResultsThe operation time was (115.0±29.9) min (range, 77-182 min), and the median blood loss during the operation was 150 ml (range, 50-300 ml). No patient experienced unintentional durotomy, neurological injury, or postoperative hematoma. The mean followup time was 18.6 months (range,12-21 months). The JOA scores increased from (12.0±2.4) points to (14.9±1.8) points (t=-20.597,P=0.000), the SF36 scores increased from (23.2±50) points to (26.5±3.8) points (t=-13.344,P=0.000), and the median NID scores decreased from 13.5 points (range, 2-34 points) to 3.5 points (range, 0-30 points) (Z=-5.521,P=0.000). The C27 Cobb angle decreased from 13.6°±57° preoperatively to 12.0°±5.8° at the final followup (t=6.467,P=0.000). The C27 range of motion decreased from 37.0°±9.1° to 31.0°±6.6° (t=13.244,P=0.000). The sagittal spinal canal diameter of C7 significantly increased from (92±2.2) mm to (128±19) mm (t=-39.622,P=0.000).ConclusionApplication of UBC in C7 dome decompression is safe and effective and may be considered a useful alternative to traditional tools.

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备注/Memo

备注/Memo:
基金项目：北京大学第三医院临床重点项目（BYSYZD2019005）**通讯作者，Email:jiangliang@bjmu.edu.cn
更新日期/Last Update: 2023-03-13