Efficacy and Safety of Ultrasonic Bone Curette-assisted Dome-like Laminoplasty in the Treatment of Cervical Ossification of Longitudinal Ligament.
Efficacy and Safety of Ultrasonic Bone Curette-assisted Dome-like Laminoplasty in the Treatment of Cervical Ossification of Longitudinal Ligament.
复制标题
超声骨刮匙辅助圆顶椎板成形术治疗颈椎纵韧带骨化的疗效和安全性。
DOI：
10.1111/os.12858
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发表时间：
2021-03
影响因子：
2.1
通讯作者：
Liu Y
中科院分区：
文献类型：
--
作者：
Sun B;Xu C;Wu S;Zhang Y;Wu H;Qi M;Shen X;Yuan W;Liu Y
评估超声骨刮匙辅助圆顶样椎板成形术治疗累及C2的纵韧带骨化症（OPLL）的有效性和安全性。共纳入64例累及C2节段的OPLL患者。38例接受超声骨刮匙辅助圆顶状椎板成形术的患者被定义为超声骨刮匙组（UBC），28例接受传统高速钻辅助圆顶状椎板成形术的患者被定义为高速钻组（HSD）。记录并比较患者特征，如年龄、性别、体重指数（BMI）、症状持续时间以及其他信息，如OPLL类型、手术时间、失血量、C2-C7 Cobb角变化和并发症。采用日本骨科协会（乔亚）评分、神经根功能改善率（IR）和视觉模拟评分（VAS）评估神经功能恢复和疼痛缓解情况。测量骨化顶点与连接椎板前缘的连续线之间的距离变化，以评估脊柱扩张程度。测量数据采用SPSS21.0软件进行统计学处理和分析，测量数据以均数±标准差表示。超声骨刮匙（UBC）组和高速钻组（HSD）中，椎板成形术的平均时间分别为52.3 ± 18.2 min和76.0 ± 21.8 min，平均出血量分别为155.5 ± 41.3 mL和177.4 ± 54.7 mL，两组之间的差异具有统计学意义。两组均表现出神经功能的显著改善。但是，6个月随访时UBC组的VAS评分低于HSD组（P < 0.05），但1年随访时无显著差异。1年随访时，UBC组的脊柱前凸丢失为1.5° ± 1.0°，显著低于HSD组（3.8° ± 1.2°，P < 0.05）。根据椎管直径的变化，UBC组椎管扩大程度与HSD组相似（P > 0.05）。UBC组中仅1例患者和HSD组中仅5例患者显示脑脊液（CSF）渗漏。在OPLL圆顶样减压术中使用超声骨刮匙，可以相对安全、快速地完成减压手术。有效减少术中出血量及并发症，颈部疼痛初期恢复较好。 我们评估了超声骨刮匙辅助圆顶样椎板成形术治疗累及C2的OPLL的有效性和安全性。我们发现使用超声骨刮匙可以相对安全地完成减压手术，术中出血量少，术后并发症少。
To assess the efficacy and safety of ultrasonic bone curette‐assisted dome‐like laminoplasty in the treatment of ossification of longitudinal ligament (OPLL) involving C2. A total of 64 patients with OPLL involving C2 level were enrolled. Thirty‐eight patients who underwent ultrasonic bone curette‐assisted dome‐like laminoplasty were defined as ultrasonic bone curette group (UBC), and 28 patients who underwent traditional high‐speed drill‐assisted dome‐like laminoplasty were defined as high‐speed drill group (HSD). Patient characteristics such as age, sex, body mass index (BMI), symptomatic duration, and other information like the type of OPLL, the time of surgery, blood loss, C2–C7 Cobb angle change and complications were all recorded and compared. The Japanese Orthopaedic Association (JOA) score, the nerve root functional improvement rate (IR), and the visual analogue scale (VAS) were used to assess neurological recovery and pain relief. The change of the distance between the apex of ossification and a continuous line connecting the anterior edges of the lamina was measured to assess the spinal expansion extent. The measured data were statistically processed and analyzed using SPSS 21.0 software, and the measurement data were expressed as mean ± SD. In ultrasonic bone curette (UBC) group and high‐speed drill group (HSD) group, the average time for laminoplasty was 52.3 ± 18.2 min and 76.0 ± 21.8 min and the mean bleeding loss volume was 155.5 ± 41.3 mL and 177.4 ± 54.7 mL, respectively, with a statistically significant difference between the groups. Both groups demonstrated a significant improvement in neurological function. However, the VAS score in UBC group was lower than in HSD group at the 6‐month follow‐up (P < 0.05), but there was no significant difference at 1‐year follow‐up. We found that the loss of lordosis was 1.5° ± 1.0° in UBC group, which is significantly lower than that of HSD group at 1‐year follow‐up (3.8° ± 1.2°, P < 0.05). According to the change of canal dimension, we found that the expansion extent of the spinal canal in UBC group was similar to that of HSD group (P > 0.05). Only one patient in the UBC group and five patients in the HSD group displayed cerebrospinal fluid (CSF) leakag. With the use of ultrasonic bone curette in OPLL dome‐like decompression, the decompression surgery could be completed relatively safely and quickly. It effectively reduced the amount of intraoperative blood loss and complications, and had better initial recovery of neck pain. We assessed the efficacy and safety of ultrasonic bone curette‐assisted dome‐like laminoplasty in the treatment of C2 involved OPLL. We found that the decompression surgery could be completed relatively safely and with less intraoperative blood loss and fewer postoperative complications by using the ultrasonic bone curette.
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影响因子：
3
作者：
MATSUZAKI, H;HOSHINO, M;TORIYAMA, S
通讯作者：
TORIYAMA, S
影响因子：
2.8
作者：
Zhang, Junwei;Hirabayashi, Shigeru;Sakai, Hiroya
通讯作者：
Sakai, Hiroya
影响因子：
3
作者：
Haller, Justin M.;Iwanik, Michael;Shen, Francis H.
通讯作者：
Shen, Francis H.
影响因子：
4.1
作者：
Shiraishi, T
通讯作者：
Shiraishi, T
影响因子：
2
作者：
Lee, Soo Eon;Jahng, Tae-Ahn;Kim, Hyun-Jib
通讯作者：
Kim, Hyun-Jib