■已经引入了低轮廓的缝线穿引器,以促进微创脊柱(MIS)手术中的胸腰椎筋膜闭合。这项研究的目的是评估现代缝线穿引器对尸体模型中MIS筋膜闭合的常规弯曲需求的闭合时间。
招募了6名专门从事骨科脊柱手术的临床医生进行研究,并随机分配了1名尸体躯干。在L4-L5切除皮下组织,复制MIS手术,然后放置60×18-mm或100×18-mm管状牵开器进入。临床医生需要用三个未打结的筋膜闭合,使用模压弯曲针或缝线穿引器进行简单的间断缝线(SpineScorpion™,Arthrex,Inc.,那不勒斯,FL).记录完成时间,在缝合前立即开始,在最后一次通过后结束。考虑到合理的手术室时间,实施10分钟的时间截止。并记录完成的缝合次数(共6次).临床医生被要求根据0-5量表对与先前的筋膜闭合经验相关的易用性进行定性分级。0是不可能的,5是最简单的。
■与使用60×18-mm牵开器(Δ=5.80min;95%CI,2.92-8.67min;p=.004)和100×18-mm牵开器(Δ=5.28min;95%CI,2.76-7.80min;p=.在所有脊柱蝎子试验的时限内实现了完全闭合,在60×18-mm和100×18-mm牵开器的试验中,标准针头在67%(6个中的4个)和50%(6个中的3个)中实现了完全闭合,分别。60×18-mm和100×18-mm牵开器的中间易用性分数,分别,是4.5(范围,4-5)和4.5(范围,3-5)对于脊柱蝎子,和1.0(范围,1-2)用于弯针。
■使用缝线穿引器进行胸腰椎筋膜闭合的实验室研究结果表明,与传统弯曲针相比,闭合时间和手术完成时间显着减少。
UNASSIGNED: Low-profile suture passers have been introduced to facilitate thoracolumbar fascia closure in minimally invasive spine (MIS) surgery. The purpose of this study was to evaluate the closure time of a modern suture passer to a conventional curved need for MIS fascia closure in a cadaveric model.
UNASSIGNED: Six clinicians specializing in orthopedic spine surgery were recruited for the study and randomly assigned 1 cadaveric torso. Subcutaneous tissue was resected at L4-L5, replicating MIS surgery, followed by placement of a 60×18-mm or 100×18-mm tubular retractor for access. Clinicians were required to close the fascia with three unknotted, simple interrupted sutures using a swaged curved needle or suture passer (Spine Scorpion™, Arthrex, Inc., Naples, FL). The completion time was recorded, starting immediately before suturing and ending after the last pass. A time cutoff of 10 min was implemented in consideration of reasonable operating room time, and the number of achieved suture passes (of 6) were recorded. Clinicians were asked to qualitatively grade ease of use in relation to prior fascial closure experience per a 0-5 scale, where 0 is impossible and 5 is easiest.
UNASSIGNED: The mean change in fascial closure completion time (Δ) was significantly reduced with the Spine Scorpion compared to the curved needle with the 60×18-mm retractor (Δ=5.80 min; 95% CI, 2.92-8.67 min; p=.004) and 100 × 18-mm retractor (Δ=5.28 min; 95% CI, 2.76-7.80 min; p=.003). Full closure was achieved within the time limit for all trials of the Spine Scorpion, while the standard needle achieved full closure in 67% (4 of 6) and 50% (3 of 6) of trials with the 60 × 18-mm and 100×18-mm retractors, respectively. Median ease-of-use scores with the 60×18-mm and 100×18-mm retractors, respectively, were 4.5 (range, 4-5) and 4.5 (range, 3-5) for the Spine Scorpion, and both 1.0 (range, 1-2) for the curved needle.
UNASSIGNED: Results from this laboratory investigation using a suture passer for thoracolumbar fascia closure show a significant reduction in closure time and completion of the procedure compared to a conventional curved needle.