颈椎开门椎板成形术使用不同工具制作门轴对开门角度的影响

doi:10.13418/j.issn.1001-165x.2021.02.021

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中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (2) : 224-227. DOI: 10.13418/j.issn.1001-165x.2021.02.021

临床研究

颈椎开门椎板成形术使用不同工具制作门轴对开门角度的影响

蔚兰哲^1,2,4，　崔尚斌^1,2，　魏富鑫³，　王乐¹，　刘少喻^1,2,3

作者信息 +

Comparison of open angle of two different methods to make hinges in cervical expansive laminoplasty

Yu Lanzhe^1,2,4, Cui Shangbin^1,2, Wei Fuxin³, Wang Le¹, Liu Shaoyu^1,2,3

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文章历史 +

摘要

目的　探究颈椎后路开门椎管扩大成形术中使用20°尖嘴咬骨钳或高速微型磨钻两种不同工具制作门轴对椎板开门角度的影响。方法　对我院脊柱外科收治的行颈椎后路开门椎管扩大成形术的患者进行前瞻性随访，根据术中门轴制作工具的不同分为咬骨钳组和磨钻组，对所有患者术前及术后1周内拍摄颈椎计算机断层扫描（Computed Tomography, CT），分别测量术前与术后CT横断面上开门节段椎板与冠状面椎体的夹角，进行统计学分析。结果　共纳入并完整随访40例患者，其中咬骨钳组23例，磨钻组17例。其中咬骨钳组术前开门节段椎板与冠状面平均夹角为（37.58±4.09）°，磨钻组为（36.19±3.92）°，无统计学差异（P=0.286），而术后咬骨钳组开门角度为（62.27±3.99）°，磨钻组为（67.17±3.48）°，具有明显差异（P<0.001）。此外，两组间患者椎板扩大角度、术前术后角度比、角度扩大率均具有统计学差异（P<0.01）。结论　使用20°尖嘴咬骨钳制作门轴较之使用高速微型磨钻，可以更加精确控制开门角度，使其不至于过大，更加接近理想开门角。

Abstract

Objective 　To investigate the effects of 20° sharp rongeur or high-speed-micro- drill on the open angle to make hinges in cervical posterior open-door expansive laminoplasty.　Methods 　Patients who received cervical posterior open-door expansive laminoplasty were collected in our hospital and were followed up prospectively. They were divided into 2 following groups according to the instrument of making hinges, which are a 20°sharp rongeur group and a high speed micro-drill group. Cervical vertebra computed tomography (CT) was performed before operation and within 1 week after operation in all patients. The angles between the lamina and the coronal vertebral body on the CT cross-section were measured before and after surgery. Then these data were statistically analyzed. Results 40 patients were collected in and were followed up, including 23 cases in the rongeur group and 17 cases in the drill group. In the rongeur group, the mean angle between the open segment lamina and the coronal plane before operation was (37.58±4.09)°, while the angle in the drill group was (36.19±3.92)°, which showed no statistical difference between them (P=0.286). And the open angle of the rongeur group after operation was (62.27±3.99)°, while (67.17±3.48)° in drill group, which were significantly different (P<0.001). In addition, there were statistical difference in the lamina expansion angle, preoperative and postoperative open angle ratio, and expansion rate of open angle between these two groups (P<0.01). Conclusions Using 20° sharp rongeur to make hinges can control the open angle more precisely and closer to the ideal open angle than using high speed micro-drill.

导出引用

蔚兰哲, 崔尚斌, 魏富鑫, 王乐, 刘少喻. 颈椎开门椎板成形术使用不同工具制作门轴对开门角度的影响[J]. 中国临床解剖学杂志. 2021, 39(2): 224-227 https://doi.org/10.13418/j.issn.1001-165x.2021.02.021

Yu Lanzhe, Cui Shangbin, Wei Fuxin, Wang Le, Liu Shaoyu. Comparison of open angle of two different methods to make hinges in cervical expansive laminoplasty[J]. Chinese Journal of Clinical Anatomy. 2021, 39(2): 224-227 https://doi.org/10.13418/j.issn.1001-165x.2021.02.021

中图分类号： R653

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