【摘要】 目的 探讨颈椎椎板成形术中应用超声骨刮匙（ultrasonic bone curette, UBC）进行C₇穹窿减压的安全性和有效性。方法 2019年9月～2020年6月我科应用UBC行C_4～6椎板成形、C₃椎板切除、C₇穹隆减压椎板成形术，观察患者手术前后日本骨科学会（Japanese Orthopedic Association, JOA）评分、生活质量量表（Short Form 36,SF-36）评分、颈椎功能障碍指数（Neck Disability Index, NDI）评分及影像学表现。结果 手术时间（115.0±29.9）min（77～182 min）,术中出血量50～300 ml（中位数150 ml）。术后住院时间平均5.1 d（3～9 d）。术后均未发生脑脊液漏、神经损伤和出血。40例随访平均18.6月（12～21个月）,末次随访JOA评分从术前（12.0±2.4）分提高到（14.9±1.8）分（t=-20.597,P=0.000）。SF-36评分从术前（23.2±5.0）分提高到（26.5±3.8）分（t=-13.344,P=0.000）;NDI评分从术前中位数13.5（2～34）分降低到3.5（0～30）分（Z=-5.521,P=0.000）;C_2～7 Cobb角由术前13.6°±5.7°下降到12.0°±5.8°（t=6.467,P=0.000）;C_2～7颈椎活动度从术前37.0°±9.1°下降到31.0°±6.6°（t=13.244,P=0.000）;C₇棘突到椎体的最小径线从术前（9.2±2.2）mm提高到（12.8±1.9）mm（t=-39.622,P=0.000）。结论 颈后路C₇椎板穹隆减压术中应用UBC安全、有效。更多还原

【Abstract】 Objective To investigate the safety and efficacy of a specialized ultrasound bone curette（UBC） in C₇ dome decompression during cervical laminoplasty. Methods Clinical data of 40 patients who underwent C_4-6 laminoplasty, C₃ laminectomy, and C₇ dome decompression with the use of a UBC from September 2019 to June 2020 were retrospectively analyzed. Patients’ Japanese Orthopedic Association（JOA） score, Short Form 36（SF-36） general life status score, neck disability index（NDI） score, and radiographic data were extracted and analyzed. Results The operation time was（115.0±29.9） min（range, 77-182 min）, and the median blood loss during the operation was 150 ml（range, 50-300 ml）. No patient experienced unintentional durotomy, neurological injury, or postoperative hematoma. The mean follow-up time was 18.6 months（range, 12-21 months）. The JOA scores increased from（12.0±2.4） points to（14.9±1.8） points（t=-20.597,P=0.000）, the SF-36 scores increased from（23.2±5.0） points to（26.5±3.8） points（t=-13.344,P=0.000）, and the median NID scores decreased from 13.5 points（range, 2-34 points） to 3.5 points（range, 0-30 points）（Z=-5.521,P=0.000）. The C_2-7 Cobb angle decreased from 13.6°±5.7° preoperatively to 12.0°±5.8° at the final follow-up（t=6.467,P=0.000）. The C_2-7 range of motion decreased from 37.0°±9.1° to 31.0°±6.6°（t=13.244,P=0.000）. The sagittal spinal canal diameter of C₇ significantly increased from（9.2±2.2） mm to（12.8±1.9） mm（t=-39.622,P=0.000）. Conclusion Application of UBC in C₇ dome decompression is safe and effective and may be considered a useful alternative to traditional tools.更多还原