临床外科杂志 ›› 2023, Vol. 31 ›› Issue (1): 80-83.doi: 10.3969/j.issn.1005-6483.2023.01.024

• 论著 • 上一篇    下一篇

超声骨刀在颈前路混合减压融合术治疗多节段脊髓型颈椎病的应用

  

  1. 430079 武汉中西医结合骨科医院(脊柱一科),武汉体育学院附属医院
  • 收稿日期:2022-03-21 接受日期:2022-03-21 出版日期:2023-01-20 发布日期:2023-01-20
  • 通讯作者: 通信作者:朱凌,Email:54167657@qq.com
  • 基金资助:
    基金项目:武汉市临床医学科研项目(WX20D19)

Application of ultrasonic osteotome in anterior cervical hybrid decompression and fusion in the treatment of multilevel cervical spondylotic myelopathy

  1. Department of Orthopedic,Wuhan Orthopaedics Hospital of Integrated Traditional Chinese and Western Medicine,the Affiliated Hospital of Wuhan Sports University,Wuhan 430079,China
  • Received:2022-03-21 Accepted:2022-03-21 Online:2023-01-20 Published:2023-01-20

摘要: 目的 探讨运用超声骨刀辅助下颈前路混合减压融合术治疗多节段脊髓型颈椎病的临床疗效。方法 2019年1月~2021年1月在超声骨刀辅助下行颈前路混合减压融合术治疗的多节段脊髓型颈椎病病人31例。分析病例围手术期、后期随访数据和影像学资料。结果 31例病人均顺利完成手术,术后3例出现一过性吞咽异物感,术后1个月1例病人出现钛网下沉,经密切观察,最终稳定融合;无椎动脉损伤、食管漏等并发症发生。术后1个月JOA、NDI评分分别为(11.23±1.41)和(14.77±3.10),末次随访JOA、NDI评分分别为(12.84±1.73)和(12.77±3.80),术后各随访时间点JOA、NDI评分较术前均改善,差异有统计学意义(P<0.05);术后1个月颈椎前凸角(Cobb角)、颈椎矢状位轴向距离(SVA)、T1倾斜角(T1S)分别为(15.44±2.39)°、(14.26±3.23)°和(28.18±4.49)°,末次随访Cobb角、SVA、T1S分别为(16.24±1.06)°、(12.96±2.43)°和(27.50±3.05)°,术后各随访时间点Cobb角、SVA、T1S均较术前提高,差异有统计学意义(P<0.05)。结论 超声骨刀辅助下颈前路混合减压融合术治疗多节段脊髓型颈椎病,近期疗效良好,可改善颈椎矢状位参数,有利于脊髓和神经功能的恢复。

关键词: 颈椎前路手术, 脊髓型颈椎病, 颈椎矢状位参数

Abstract: Objective To explore the clinical effect of ultrasonic osteotome assisted anterior cervical hybrid decompression and fusion in the treatment of multilevel cervical spondylotic myelopathy.Methods From January 2019 to January 2021,patients with multilevel cervical spondylotic myelopathy treated by ultrasonic osteotome assisted anterior cervical hybrid decompression and fusion were studied retrospectively(31 cases).The perioperative and late follow-up data and imaging data of all cases were collected.Results All 31 patients successfully completed the operation.3 patients had transient swallowing foreign body sensation after operation,and 1 patient had titanium mesh sinking after 1 month.After close observation,they finally fused stably.No serious complications such as vertebral artery injury and esophageal fistula occurred.The JOA and NDI scores were(11.23±1.41),(14.77±3.10) at 1 month after operation,and the JOA and NDI scores at the last follow-up were(12.84±1.73),(12.77±3.80),respectively.JOA and NDI scores at each follow-up time point after operation were improved compared with those before operation(P<0.05).One month after operation,the cervical lordosis angle(Cobb angle),sagittal axial distance(SVA) and T1 tilt angle(T1s) were(15.44±2.39)°,(14.26±3.23)°,(28.18±4.49)°, respectively.At the last follow-up, the Cobb angle,SVA and T1s were(16.24±1.06),(12.96±2.43),(27.50±3.05),respectively.The Cobb angle,SVA and T1S were higher than those before operation(P<0.05).Conclusion Ultrasonic osteotome assisted anterior cervical hybrid decompression and fusion in the treatment of multilevel cervical spondylotic myelopathy has good short-term effect,and can effectively improve the sagittal parameters of cervical spine,which is conducive to the recovery of spinal cord and nerve function.

Key words: anterior cervical surgery, cervical spondylotic myelopathy, sagittal parameters of cervical spine

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