目的系统评价超声骨刀辅助腰椎后路椎体间融合术(PLIF)治疗腰椎管狭窄症(LSS)的有效性与安全性。方法检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library及Web of Science数据库,收集各数据库建...目的系统评价超声骨刀辅助腰椎后路椎体间融合术(PLIF)治疗腰椎管狭窄症(LSS)的有效性与安全性。方法检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library及Web of Science数据库,收集各数据库建库至2023年1月有关超声骨刀辅助PLIF治疗LSS的临床研究,由2名研究者独立进行文献筛选、资料提取、数据核对及质量评价,结局指标使用RevMan 5.4软件进行荟萃分析。结果①共纳入12篇文献,其中4篇随机对照试验,8篇回顾性队列研究;共涉及1069例患者,试验组559例,对照组510例;②荟萃分析结果显示:与传统器械组相比,超声骨刀组能显著改善视觉模拟评分法(VAS)评分[MD=-0.41,95%CI(-0.60,-0.23),P<0.00001]和Oswestry功能障碍指数(ODI)评分[MD=-1.50,95%CI(-2.31,-0.69),P=0.0003],降低术中出血量[MD=-60.05,95%CI(-72.51,-47.59),P<0.00001]和并发症发生率[RR=0.29,95%CI(0.16,0.52),P<0.0001],缩短椎板切除时间[MD=-1.51,95%CI(-2.48,-0.54),P=0.002]。结论超声骨刀辅助PLIF手术在降低VAS、ODI、术中出血量及并发症发生率、缩短椎板切除时间方面均有显著优势。展开更多
目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临...目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临床资料,男25例,女17例;年龄30~74(53.9±11.0)岁。单节段病变18例,2个节段病变17例,3个节段病变7例。分别在术前和术后6个月时采用美国耳鼻咽喉头颈外科学会听力及平衡委员会评分(Committee on Hearing and Equilibrium,CHE)、颈椎功能障碍指数(neck disability index,NDI)和颈椎曲度Cobb角进行临床疗效评价。结果:42例患者均获随访,随访时间6~30(14.0±5.2)个月;手术时间95~220(160.38±36.77)min,术中出血量30~85(53.60±18.98)ml。2例术后出现轻度吞咽困难,给予雾化吸入等对症处理后均好转。CHE评分由术前(4.05±0.96)分降低至术后6个月的(2.40±0.70)分(t=12.97,P<0.05)。术后6个月38例眩晕改善,改善率90.5%。NDI评分的由术前的(34.43±8.04)分降低至术后6个月的(20.76±3.91)分(t=11.83,P<0.05)。颈椎曲度Cobb角由术前的(8.04±6.70)°提高至术后6个月的(12.42±5.23)°(t=-15.96,P<0.05)。结论:ACDF术式治疗椎动脉型颈椎病的临床疗效突出,手术通过解除骨性压迫,重建颈椎曲度,可快速缓解患者的发作性眩晕症状。但需要严格把握手术指征,明确患者眩晕原因,对保守治疗无效的CSA患者,ACDF手术可推荐使用。展开更多
目的:评估零切迹椎间融合器应用于颈椎前路椎间盘切除植骨融合术(ACDF)治疗脊髓型颈椎病(CSM)的临床效果,观察术后并发症发生情况。方法:纳入2021年1月至2022年12月期间,在云南中医药大学第一附属医院接受ACDF手术治疗的34例脊髓型颈椎...目的:评估零切迹椎间融合器应用于颈椎前路椎间盘切除植骨融合术(ACDF)治疗脊髓型颈椎病(CSM)的临床效果,观察术后并发症发生情况。方法:纳入2021年1月至2022年12月期间,在云南中医药大学第一附属医院接受ACDF手术治疗的34例脊髓型颈椎病患者,所有患者使用零切迹椎间融合器。分别评估患者的疼痛VAS评分、椎间隙高度、颈椎Cobb角以及融合节段的Cobb角,并观察术后并发症(如吞咽困难)和植骨融合情况。结果:34例患者术后疼痛VAS评分显著改善,椎间隙高度、颈椎Cobb角和融合节段Cobb角均较术前明显改善。术后2例患者出现吞咽困难,但症状在一周内缓解,最终完全消失。所有患者椎间骨性融合成功,且术后并发症发生率较低。结论:零切迹椎间融合器在ACDF手术中应用具有显著的临床效果,能够改善椎间隙高度、颈椎Cobb角及融合节段的Cobb角,且术后并发症发生率较低。Objective: To evaluate the clinical efficacy of zero-profile interbody fusion devices in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical spondylotic myelopathy (CSM), and to observe the incidence of postoperative complications. Methods: A total of 34 patients with CSM who underwent ACDF using zero-profile interbody fusion devices at the First Affiliated Hospital of Yunnan University of Chinese Medicine from January 2021 to December 2022 were included. The pain visual analogue scale (VAS) score, intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were assessed. The incidence of postoperative complications (e.g., dysphagia) and bone graft fusion were also observed. Results: Postoperatively, the VAS scores for pain significantly improved in all 34 patients. The intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were also significantly better compared to preoperative values. Two patients experienced dysphagia, which resolved within one week and completely disappeared. All patients achieved successful intervertebral bony fusion, with a low incidence of postoperative complications. Conclusion: The use of zero-profile interbody fusion devices in ACDF demonstrates significant clinical efficacy, improving intervertebral height, cervical Cobb angle, and fusion segment Cobb angle, with a low incidence of postoperative complications.展开更多
文摘目的系统评价超声骨刀辅助腰椎后路椎体间融合术(PLIF)治疗腰椎管狭窄症(LSS)的有效性与安全性。方法检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library及Web of Science数据库,收集各数据库建库至2023年1月有关超声骨刀辅助PLIF治疗LSS的临床研究,由2名研究者独立进行文献筛选、资料提取、数据核对及质量评价,结局指标使用RevMan 5.4软件进行荟萃分析。结果①共纳入12篇文献,其中4篇随机对照试验,8篇回顾性队列研究;共涉及1069例患者,试验组559例,对照组510例;②荟萃分析结果显示:与传统器械组相比,超声骨刀组能显著改善视觉模拟评分法(VAS)评分[MD=-0.41,95%CI(-0.60,-0.23),P<0.00001]和Oswestry功能障碍指数(ODI)评分[MD=-1.50,95%CI(-2.31,-0.69),P=0.0003],降低术中出血量[MD=-60.05,95%CI(-72.51,-47.59),P<0.00001]和并发症发生率[RR=0.29,95%CI(0.16,0.52),P<0.0001],缩短椎板切除时间[MD=-1.51,95%CI(-2.48,-0.54),P=0.002]。结论超声骨刀辅助PLIF手术在降低VAS、ODI、术中出血量及并发症发生率、缩短椎板切除时间方面均有显著优势。
文摘目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临床资料,男25例,女17例;年龄30~74(53.9±11.0)岁。单节段病变18例,2个节段病变17例,3个节段病变7例。分别在术前和术后6个月时采用美国耳鼻咽喉头颈外科学会听力及平衡委员会评分(Committee on Hearing and Equilibrium,CHE)、颈椎功能障碍指数(neck disability index,NDI)和颈椎曲度Cobb角进行临床疗效评价。结果:42例患者均获随访,随访时间6~30(14.0±5.2)个月;手术时间95~220(160.38±36.77)min,术中出血量30~85(53.60±18.98)ml。2例术后出现轻度吞咽困难,给予雾化吸入等对症处理后均好转。CHE评分由术前(4.05±0.96)分降低至术后6个月的(2.40±0.70)分(t=12.97,P<0.05)。术后6个月38例眩晕改善,改善率90.5%。NDI评分的由术前的(34.43±8.04)分降低至术后6个月的(20.76±3.91)分(t=11.83,P<0.05)。颈椎曲度Cobb角由术前的(8.04±6.70)°提高至术后6个月的(12.42±5.23)°(t=-15.96,P<0.05)。结论:ACDF术式治疗椎动脉型颈椎病的临床疗效突出,手术通过解除骨性压迫,重建颈椎曲度,可快速缓解患者的发作性眩晕症状。但需要严格把握手术指征,明确患者眩晕原因,对保守治疗无效的CSA患者,ACDF手术可推荐使用。
文摘目的:评估零切迹椎间融合器应用于颈椎前路椎间盘切除植骨融合术(ACDF)治疗脊髓型颈椎病(CSM)的临床效果,观察术后并发症发生情况。方法:纳入2021年1月至2022年12月期间,在云南中医药大学第一附属医院接受ACDF手术治疗的34例脊髓型颈椎病患者,所有患者使用零切迹椎间融合器。分别评估患者的疼痛VAS评分、椎间隙高度、颈椎Cobb角以及融合节段的Cobb角,并观察术后并发症(如吞咽困难)和植骨融合情况。结果:34例患者术后疼痛VAS评分显著改善,椎间隙高度、颈椎Cobb角和融合节段Cobb角均较术前明显改善。术后2例患者出现吞咽困难,但症状在一周内缓解,最终完全消失。所有患者椎间骨性融合成功,且术后并发症发生率较低。结论:零切迹椎间融合器在ACDF手术中应用具有显著的临床效果,能够改善椎间隙高度、颈椎Cobb角及融合节段的Cobb角,且术后并发症发生率较低。Objective: To evaluate the clinical efficacy of zero-profile interbody fusion devices in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical spondylotic myelopathy (CSM), and to observe the incidence of postoperative complications. Methods: A total of 34 patients with CSM who underwent ACDF using zero-profile interbody fusion devices at the First Affiliated Hospital of Yunnan University of Chinese Medicine from January 2021 to December 2022 were included. The pain visual analogue scale (VAS) score, intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were assessed. The incidence of postoperative complications (e.g., dysphagia) and bone graft fusion were also observed. Results: Postoperatively, the VAS scores for pain significantly improved in all 34 patients. The intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were also significantly better compared to preoperative values. Two patients experienced dysphagia, which resolved within one week and completely disappeared. All patients achieved successful intervertebral bony fusion, with a low incidence of postoperative complications. Conclusion: The use of zero-profile interbody fusion devices in ACDF demonstrates significant clinical efficacy, improving intervertebral height, cervical Cobb angle, and fusion segment Cobb angle, with a low incidence of postoperative complications.
