SO SÁNH KẾT QUẢ PHẪU THUẬT GIẢI ÉP TRONG HẸP ỐNG SỐNG NGỰC CÓ TỔN THƯƠNG TUỶ SỬ DỤNG DAO CẮT XƯƠNG SIÊU ÂM VÀ PHƯƠNG PHÁP GIẢI ÉP TRUYỀN THỐNG SỬ DỤNG KERRISON Ở BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objectives: To compare the surgical outcomes of decompression for thoracic spinal stenosis with myelopathy using an ultrasonic osteotome versus the traditional Kerrison-assisted decompression method at the Spine Surgery Department of Viet Duc University Hospital from January 2022 to January 2024. Methods: This was a retrospective, descriptive study involving two groups: Group A, consisting of 55 patients who underwent traditional decompression, and Group B, with 50 patients who underwent decompression using an ultrasonic osteotome. Results: Among the study patients, the mean preoperative mJOA score was 5.1 ± 1.2 in Group A and 5.4 ± 1.3 in Group B. Postoperatively, the mJOA score improved to 7.1 ± 1.4 in Group A and 9.2 ± 1.5 in Group B. Patients in Group B showed a significantly greater improvement in mJOA scores compared to Group A (P<0.01). Operative time, blood loss, and hospital stay were all significantly lower in Group B than in Group A (P<0.01). Neurological injury occurred in 5 patients in Group A (9.1%) compared to 1 patient in Group B (2%). Dural tears were observed in 12.7% of patients in Group A versus 6% in Group B. Conclusion: The use of an ultrasonic osteotome for decompression in thoracic spinal stenosis may reduce the risk of neurological injury and improve postoperative neurological function compared to the traditional method. Additionally, the use of an ultrasonic bone scalpel contributes to reduced blood loss, operative time, and hospital stay.