[1]唐晓东,王瑞博,樊彦伟,等.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[J].中国中医骨伤科杂志,2023,31(10):45-49.[doi:10.20085/j.cnki.issn1005-0205.231009]
 TANG Xiaodong,WANG Ruibo,FAN Yanwei,et al.Clinical Efficacy of Posterior Endoscopic Decompression via Large-Channel for Cervical Spondylotic Radiculopathy[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(10):45-49.[doi:10.20085/j.cnki.issn1005-0205.231009]
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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()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年10期
页码:
45-49
栏目:
临床论著
出版日期:
2023-10-15

文章信息/Info

Title:
Clinical Efficacy of Posterior Endoscopic Decompression via Large-Channel for Cervical Spondylotic Radiculopathy
文章编号:
1005-0205(2023)10-0045-05
作者:
唐晓东1王瑞博1樊彦伟1张长江1闫鹏1△
1郑州大学第五附属医院(郑州,450052)
Author(s):
TANG Xiaodong1WANG Ruibo1FAN Yanwei1ZHANG Changjiang1YAN Peng1△
1The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China.
关键词:
大通道 内镜减压 神经根型颈椎病
Keywords:
large-channel endoscopic decompression cervical spondylotic radiculopathy
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.231009
文献标志码:
A
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。
Abstract:
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.

参考文献/References:

[1] RUETTEN S,KOMP M,MERK H,et al.A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes:prospective 2-year results of 87 patients[J].Minim Invas Neurosurg,2007,50(4):219-226.
[2] AHN Y,YOUN M S,HEO D H.Endoscopic transforaminal lumbar interbody fusion:a comprehensive review[J].Expert Rev Med Devices,2019,16(5):373-380.
[3] CHENG X K,CHEN B.Percutaneous endoscopic thoracic decompression for thoracic spinal stenosis under local anesthesia[J].World Neurosurg,2020,139:488-494.
[4] HUSKISSON E C,JONES J,SCOTT P J.Application of visual analogue scales to the measurement of functional capacity[J].Rheumatol Rehabil,1976,15(3):185-187.
[5] SWANENBURG J,HUMPHREYS K,LANGENFELD A,et al.Validity and reliability of a German version of the neck disability index(NDI-G)[J].Man Ther,2014,19(1):52-58.
[6] MACNAB I.Negative disc exploration:an analysis of the causes of nerve-root involvement in sixty-eight patients[J].J Bone Joint Surg Am,1971,53(5):891-903.
[7] EPSTEIN N E.A review of complication rates for anterior cervical diskectomy and fusion(ACDF)[J].Surg Neurol Int,2019,10:100.
[8] ZEKAJ E,IESS G,SERVELLO D.et al.Anterior cervical spine surgical complications:safety comparison between teacher and student[J].Surg Neurol Int,2021,12:43.
[9] CHO T G,KIM Y B,PARK S W.Long term effect on adjacent segment motion after posterior cervical foraminotomy[J].Korean J Spine,2014,11(1):1-6.
[10] PRICE R L,CORIC D,RAY W Z.Cervical total disc replacement:complications and complication avoidance[J].Neurosurg Clin N Am,2021,32(4):473-481.
[11] 王想福,张万乾,郑卉卉,等.后路经皮脊柱内镜下髓核摘除术治疗神经根型颈椎病35例[J].中国中医骨伤科杂志,2021,29(11):47-51.
[12] WU B,XIONG C,TAN L,et al.Clinical outcomes of MED and iLESSYS Delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis:a comparison study[J].Exp Ther Med,2020,20(6):252.
[13] 李齐付,白明亮,崔世忠,等.后路经皮内窥镜下颈椎髓核摘除术治疗单节段神经根型颈椎病的临床研究[J].中国现代手术学杂志,2022,26(2):103-107.
[14] KIM C H,SHIN K H,CHUNG C K,et al.Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy[J].Global Spine J,2015,5(1):31-38.
[15] CARR D A,ABECASSIS I J,HOFSTETTER C P.Full endoscopic unilateral laminotomy for bilateral decompression of the cervical spine:surgical technique and early experience[J].J Spine Surg,2020,6(2):447-456.
[16] 陈松,张为,索世琪,等.颈后路经皮大通道全内镜椎板减压术治疗单节段脊髓型颈椎病的临床效果观察[J].中华解剖与临床杂志,2021,26(1):61-67.
[17] NAKAMURA S,TAGUCHI M.Area of ostectomy in posterior percutaneous endoscopic cervical foraminotomy:images and mid-term outcomes[J].Asian Spine J,2017,11(6):968-974.
[18] YANG J S,CHU L,CHEN L,et al.Anterior or posterior approach of full-endoscopic cervical discectomy for cervical intervertebral disc herniation? A comparative cohort study[J].Spine(Phila Pa 1976),2014,39(21):1743-1750.
[19] 吴鹏飞,李亚伟,王冰,等.经皮完全内窥镜与显微内窥镜下后路颈椎间孔切开减压术围手术期并发症的Meta分析[J].中国脊柱脊髓杂志,2018,28(7):620-628.
[20] 王耀斌,陈书连,张锴,等.多模式神经电生理辅助下经皮内镜下颈椎间盘切除术的早期疗效观察[J].中华医学杂志,2020,100(25):1956-1961.

备注/Memo

备注/Memo:
基金项目: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)
通信作者 E-mail:179455419@qq.com
更新日期/Last Update: 2023-10-01