摘要
目的:探讨后路经皮大通道全可视内镜减压术治疗神经根型颈椎病的临床疗效。方法:回顾性分析2017年1月至2022年3月52例神经根型颈椎病患者,行后路经皮大通道全可视内镜减压术的临床资料,统计手术时间、出血量、术后卧床时间和并发症情况,记录手术前后颈痛、上肢痛视觉模拟量表(VAS)评分、颈部功能残障指数(NDI)评分,采用改良MacNab评估疗效。结果:所有手术均顺利完成,平均手术时间为(68.8±15.2)min,平均出血量为(16.2±10.4)mL,平均术后卧床时间为(12.2±2.6)h,平均随访时间为(26.1±8.6)个月。术后3个月、6个月、末次随访时颈痛及上肢痛VAS评分和NDI评分均较术前降低,差异有统计学意义(P<0.05)。末次随访MacNab评估改善情况:优36例,良12例,可4例,差0例,优良率为92.3%。术后影像学复查见神经减压充分,无复发和序列不稳病例。结论:后路经皮大通道全可视内镜减压术可缓解疼痛,改善颈椎功能,安全可靠,效率高,出血少,卧床时间短,是神经根型颈椎病手术方式的一种选择。
Objective:To evaluate clinical efficacy of posterior endoscopic decompression via large-channel in the treatment of single-segment cervical spondylotic radiculopathy.Methods:52 patients with single-segment cervical spondylotic radiculopathy treated by cervical endoscopic decompression via large-channel from January 2017 to March 2022 were analyzed retrospectively.The operative time,intraoperative blood loss,postoperative time of lying in bed and hospitalization stay and complications were recorded.Visual analogue scale(VAS)scores of neck and arm,and neck disability index(NDI)scores before and after surgery were recorded.Modified MacNab criteria was used to evaluate the clinical efficacy.Results:All operations were operated successfully.The average operation time,intraoperative blood loss,postoperative time of lying in bed,and the mean follow-up time were(68.8±15.2)min,(16.2±10.4)mL,(12.2±2.6)h,and(26.1±8.6)months.VAS scores of neck and arm,NDI scores at 3 months,6 months postoperatively and the latest follow-up all decreased,the differences between preoperation and postoperation showed statistical significance(P<0.05).According to the modified MacNab criteria,the lastest follow-up the clinical outcomes were marked as excellent in 36 cases,good in 12 cases,fair in 4 cases,and poor in 0 case,the excellent and good rate was 92.3%.During the follow-up,radiology examinations showed nerve decompression was sufficient without disc herniation recurrence and unstable alignment.Conclusion:Posterior endoscopic decompression via large-channel is reliable for single-segment cervical spondylotic radiculopathy by improving the cervical function and relieving the pain of patients,and has the advantages of minimally invasive,less bleeding,shorter bed rest time and hospitalization stay.It becomes a powerful supplement to the surgical method for cervical spondylotic radiculopathy.
作者
唐晓东
王瑞博
樊彦伟
张长江
闫鹏
TANG Xiaodong;WANG Ruibo;FAN Yanwei;ZHANG Changjiang;YAN Peng(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国中医骨伤科杂志》
CAS
2023年第10期45-49,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
河南省医学科技攻关联合共建项目(2018020254)
河南省科技厅科技攻关与重点研发项目(1365)。
关键词
大通道
内镜减压
神经根型颈椎病
large-channel
endoscopic decompression
cervical spondylotic radiculopathy
