超声骨刀在退变性脊柱后凸截骨中的应用

目的 :探讨超声骨刀在退变性脊柱后凸截骨术中的有效性和安全性。方法 :回顾性分析2014年2月至2016年5月收治的32例退变性脊柱后凸患者临床资料,其中男12例,女20例;年龄50⁷1(62.1±12.3)岁;术前Cobb角25.3°³6.7°,平均(28.6±10.2)°。32例患者均使用多节段Ponte截骨联合后路长节段内固定术,根据术中截骨工具不同分为传统工具组(A组,18例)和超声骨刀组(B组,14例)。记录手术时间、术中平均椎板切除时间、截骨节段数、术中出血量、术后引流量、住院时间及并发症情况。术前及术后1个月采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评价临床疗效。结果:32例患者均获随访,时间8²4个月,平均16.4个月。两组患者手术时间、住院时间比较差异无统计学意义(P>0.05)。术中平均单椎板切除时间A组多于B组(P<0.05);截骨节段数A组少于B组(P<0.05);术中出血量及术后引流量A组均多于B组(P<0.05)。两组术后VAS和ODI比较差异无...

Application of ultrasonic bone knife in osteotomy of degenerative kyphosis

Objective: To explore the safety and effectivity of ultrasonic bone knife in osteotomy of degenerative kyphosis.Methods: The clinical data of 32 patients with degenerative kyphosis treated from February 2014 to May 2016 were retrospectively analyzed. There were 12 males and 20 females,aged 50 to 71 years with an average of (62.1±12.3) years. Preoperative Cobb angle was 25.3° to 36.7° with an average of(28.6±10.2)°. All patients underwent multi-segment Ponte osteotomy combined with posterior long segmental internal fixation. According to different osteotomy tools,the patients were divided into traditional tool group (group A,18 cases) and ultrasonic bone knife group(group B,14 cases). The operation time,laminectomy time,number of osteotomy segments,intraoperative blood loss,postoperative drainage,hospitalization time and postoperative complications were recorded.Visual analogue scale(VAS) and Oswestry Disability Index(ODI) were used to evaluate clinical outcomes before and 1 month after surgery.Results: All the patients were followed up from 8 to 24 months with an average of 16.4 months. There were no significant differences in operative time and hospitalization time between two groups(P>0.05). Intraoperative single laminectomy time of group A was more than that of group B(P<0.05). The number of osteotomy segments in group A was less than that in group B(P<0.05). Intraoperative blood loss and postoperative drainage in group A were more than that in group B(P<0.05). There were no significant differences in VAS and ODI between two groups(P>0.05). There were no dural,nerve and spinal cord injuries in both groups,and there were no complications such as improper operation of the instrument and nonunion of the osteotomy.Conclusion: The use of ultrasonic bone knife for Ponte osteotomy is safe and effective. It can effectively save the time of single laminectomy while reducing the amount of intraoperative blood loss and postoperative drainage. The safety and clinical efficacy of ultrasonic bone knife are no less than traditional tools.