[Application of absorbable hemostatic fluid gelatin in anterior cervical subtotal vertebral resection and fusion]

Objective: To explore the hemostatic effect of absorbable hemostatic fluid gelatin in single anterior cervical subtotal corpectomy and decompression fusion (ACCF) .

Methods: From August 2014 to February 2018, 44 patients with single anterior cervical corpectomy decompression and fusion were selected and divided into two groups：22 cases in experimental group including 10 males and 12 females with an average age of (55.6±9.7) years old, were treated by hemostasis with absorbable hemostasis fluid gelatin; 22 cases in control group including 11 males and 11 females with an average age of (54.4± 11.1) years old were treated by hemostasis with traditional hemostasis method. The operation time, decompression time, intraoperative hemorrhage, postoperative negative pressure drainage, postoperative neurological improvement rate (JOA%) , postoperative bone fusion time, postoperative titanium mesh subsidence rate, postoperative hematoma and other postoperative complications were compared between the two groups.

Results: The operative time of the experimental group (83.1±19.2) min was significantly shorter than that of the control group (89.5±17.0) min (P<0.05) ; the decompression time of the spinal canal in the two groups was (52.4±13.7) , (56.1±14.6) min, with a statistically significant difference (P=0.001) ; the amount of bleeding in the two groups was (49.9±12.4) , (90.6±36.7) ml, with a statistically significant difference (P<0.05) ; the total amount of drainage in the negative pressure drainage ball after operation in the two groups was (42.5±18.3) , (60.0±22.8) ml, the difference was statistically significant (P<0.05) . There was no statistically significant difference in the improvement rate of nerve function between the two groups at 1 week after operation, and the improvement rate of nerve function in the experimental group was better than that in the control group at 3 and 6 months after operation. In the two groups, bone fusion was obtained 6 months after operation, no obvious titanium mesh subsidence was found in 3 months after operation, no acute hematoma, CSF leakage and other postoperative complications were found.

Conclusion: Absorbable hemostatic fluid gelatin has a significant hemostatic effect in ACCF operation, can maintain a good operation field, can reduce the decompression time of spinal canal, reduce the amount of bleeding during operation and the amount of bleeding after operation. It is a more effective and safe hemostatic material than the traditional hemostatic method.