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

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

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

1. 中山大学附属第一医院脊柱外科，广州 510080； 2. 中山大学附属第一医院骨科研究所，广州 510080；
3. 中山大学附属第七医院骨科，深圳 518000；　4. 珠海市人民医院（暨南大学附属珠海医院），骨科珠海 519000

收稿日期:2019-05-03 出版日期:2021-03-25 发布日期:2021-04-08
通讯作者: 刘少喻，教授，博士生导师，E-mail: gzsyliu@tom.com
作者简介:蔚兰哲（1992-），男，河南人，医学博士，主要从事脊柱外科相关研究，Tel：13580467690，E-mail: lanz92@126.com
基金资助:
广州市科技项目（K0221007）;广东省自然科学基金（K0213181）

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

1. Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; 2. Orthopedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; 3. Department of Orthopedic Surgery, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China; 4, Department of Orthopedic Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai 519000, China

Received:2019-05-03 Online:2021-03-25 Published:2021-04-08

摘要/Abstract

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。

关键词: 颈椎椎管扩大成形术, 　开门角度, 　尖嘴咬骨钳, 　高速微型磨钻

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.

Key words: Cervical vertebra expansive laminoplasty;　Open angle, Sharp rongeur;　High- speed-micro-drill

中图分类号:

R653

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.

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.

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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

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

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