摘要
目的:观察脊柱内镜下颈椎椎板开窗减压术治疗脊髓型颈椎病(CSM)的临床疗效。方法:选取南昌市洪都中医院2019年7月—2021年12月收治入院的CSM患者60例,随机分为观察组和对照组,各30例。观察组采用脊柱内镜下颈椎椎板开窗减压;对照组采用颈椎前路间盘切除减压融合术(ACDF)。对2组患者手术时间、出血量、透视次数、住院时间、疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)进行评价,并收集并发症发生情况。结果:观察组手术时间、出血量、透视次数及住院时间均优于对照组,差异均有统计学意义(P<0.05)。2组患者VAS评分、NDI评分随时间的进展均呈下降趋势,术后较术前明显降低,后趋于平稳。VAS评分、NDI评分术后、术后半年观察组优于对照组(P<0.05),而术后1年则差异无统计学意义(P>0.05)。对照组出现2例切口延迟愈合,勤换药后均愈合;观察组未出现并发症。结论:采用脊柱内镜下颈椎椎板开窗减压术与ACDF术治疗CSM,均可有效改善疼痛及功能障碍。脊柱内镜下颈椎椎板开窗减压术可明显缩短手术时间及住院时间,减少出血量及术中透视次数,短期临床疗效较好,可作为治疗CSM的新选择。
Objective:To observe the clinical efficacy of endoscopic posterior cervical laminectomy for the treatment of cervical spondylotic myelopathy(CSM).Methods:Sixty patients with CSM who were admitted to Nanchang Hongdu Traditional Chinese Medicine Hospital from July 2019 to December 2021 were selected and divided into two groups:the endoscopic group(30 cases),which underwent EPCL,and the anterior cervical discectomy and fusion(ACDF)group(30 cases).Surgical time,blood loss,fluoroscopy times,hospitalization time,visual analogue scale(VAS)for pain,and neck disability index(NDI)were evaluated for both groups,and the incidence of complications was collected.Results:The surgical time,blood loss,fluoroscopy times,and hospitalization time in the endoscopic group were superior to those in the ACDF group,and the differences were statistically significant(P<0.05).VAS and NDI scores in both groups decreased over time,and were significantly lower after surgery than before.The scores became stable over time.The endoscopic group had better VAS and NDI scores than the ACDF group at postoperative and 6 months postoperatively(P<0.05),while there was no significant difference between the two groups at 1 year postoperatively(P>0.05).Two cases of delayed wound healing were observed in the ACDF group,which healed after frequent dressing changes,while no complications occurred in the endoscopic group.Conclusion:Endoscopic posterior cervical laminectomy and ACDF are effective treatments for CSM,improving pain and functional impairment.endoscopic posterior cervical laminectomy can significantly shorten surgical time and hospitalization time,reduce blood loss and intraoperative fluoroscopy times,and has good short-term clinical efficacy,making it a new choice for the treatment of CSM.
作者
刘新权
陶志强
范少勇
刘欢
江亮
LIU Xin-quan;TAO Zhi-qiang;FAN Shao-yong;LIU Huan;JIANG Liang(Nanchang Hongdu Traditional Chinese Medicine Hospital,Nanchang 330008,China;Nanchang Xinhua Hospital,Nanchang 330004,China)
出处
《江西中医药大学学报》
2023年第6期38-41,共4页
Journal of Jiangxi University of Chinese Medicine
基金
江西省卫生健康委科技支撑项目(SKJP220210111)。
关键词
脊髓型颈椎病
脊柱内镜
颈椎前路间盘切除减压融合术
椎板开窗减压
Cervical Spondylotic Myelopathy
Anterior Cervical Discectomy and Fusion
ACDF
Lamina Fenestration Decompression
