[1]柴庆国,李春根,柳根哲,等.低温等离子髓核消融术治疗颈椎间盘突出症临床研究[J].中国中医骨伤科杂志,2023,31(05):54-59.[doi:10.20085/j.cnki.issn1005-0205.230511]
 CHAI Qingguo,LI Chungen,LIU Genzhe,et al.Clinical Study of Percutaneous Cervical Disc Nucleoplasty on the Treatment of Cervical Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(05):54-59.[doi:10.20085/j.cnki.issn1005-0205.230511]
点击复制

低温等离子髓核消融术治疗颈椎间盘突出症临床研究()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年05期
页码:
54-59
栏目:
临床研究
出版日期:
2023-05-15

文章信息/Info

Title:
Clinical Study of Percutaneous Cervical Disc Nucleoplasty on the Treatment of Cervical Disc Herniation
文章编号:
1005-0205(2023)05-0054-06
作者:
柴庆国1李春根2柳根哲2尹辛成2孙佩宇2靳宜2陈超2郑皓云2祝永刚2赵思浩2
1北京中医药大学(北京,100029)
2首都医科大学附属北京中医医院骨科
Author(s):
CHAI Qingguo1LI Chungen2LIU Genzhe2YIN Xincheng2SUN Peiyu2JIN Yi2CHEN Chao2ZHENG Haoyun2ZHU Yonggang2ZHAO Sihao2
1Beijing University of Chinese Medicine,Beijing 100029,China;
2Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China.
关键词:
颈椎间盘突出症 低温等离子髓核消融术 中期疗效 影响因素 多因素逻辑回归分析
Keywords:
cervical disc herniation percutaneous cervical disc nucleoplasty medium-term efficacy influencing factors multivariate logistic regression analysis
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.230511
文献标志码:
A
摘要:
目的:探讨低温等离子髓核消融术(Percutaneous Cervical Disc Nucleoplasty,PCDN)治疗颈椎间盘突出症(Cervical Disc Herniation,CDH)的中期疗效及其影响因素。方法:回顾性分析2019年1月至2020年1月行低温等离子髓核消融术治疗的80例颈椎间盘突出症患者资料,所有患者术后均获随访2年,根据颈椎功能障碍指数(NDI)评分、视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分和改良MacNab标准评价低温等离子髓核消融术治疗颈椎间盘突出症的临床疗效。对患者的性别、体重指数(BMI)、手术节段、主要症状、年龄及病程进行单因素分析和多因素逻辑回归分析,探讨低温等离子髓核消融术的影响因素。结果:与术前相比,所有患者术后2年的NDI评分、VAS评分、JOA评分显著降低,差异有统计学意义(P<0.05)。末次随访时,优22例,良32例,中7例,差19例,总优良率为67.5%。单因素分析显示,年龄、病程、是否以头晕为主要症状均是临床疗效的影响因素; 多因素回归分析显示,年龄在20~30岁(OR=0.107)、病程<6个月(OR=0.506)以及以头晕为主要症状(OR=0.176)的患者,临床效果及预后相对较好。结论:低温等离子髓核消融术治疗颈椎间盘突出症具有良好的中期疗效,年龄小、病程短、以头晕为主的颈椎间盘突出症患者临床疗效相对较好。
Abstract:
Objective:To investigate the medium-term efficacy and influencing factors of percutaneous cervical disc nucleoplasty(PCDN)on the treatment of cervical disc herniation(CDH).Methods:The data of 80 patients with CDH treated by PCDN from January 2019 to January 2020 were analyzed retrospectively.All patients were followed up for 2 years.The clinical efficacy of PCDN on the treatment of CDH was evaluated according to neck disability index(NDI)score,visual analogue scale(VAS)score,Japanese orthopaedic association(JOA)score and modified MacNab standard.The sex,body mass index(BMI),operative segment,main symptoms,age and course of disease were analyzed by univariate analysis and multivariate logical regression analysis to explore the influencing factors of hypothermic plasma nucleus pulposus ablation.Results:Compared with those before operation,NDI score,VAS score and JOA score of all patients decreased significantly 2 years after operation(P<0.05).At the last follow-up,the results were excellent in 22 cases,good in 32 cases,fair in 7 cases and poor in 19 cases.The total excellent and good rate was 67.5%.Univariate analysis showed that age,course of disease and dizziness were the main symptoms of dizziness,while multivariate regression analysis showed that patients aged from 20 to 30 years old(OR=0.107),course of disease less than 6 months(OR=0.506)and dizziness as the main symptom(OR=0.176)had a good overall prognosis.Conclusion:PCDN has a good medium-term efficacy on the treatment of CDH,and the clinical efficacy of CDH patients with young age,short course of disease and dizziness is relatively good.

参考文献/References:

[1] 雷晴宇,王晓英,何金莲.颈椎间盘突出症的临床治疗研究进展[J].实用中西医结合临床,2019,19(4):178-180.
[2] 杨永龙,付凯,韩世杰,等.颈椎前路微创手术的研究进展[J].中华骨与关节外科杂志,2020,13(12):1046-1050.
[3] 张金鑫,林学武.低温等离子射频消融术治疗颈椎间盘突出症的疗效及其影响因素[J].颈腰痛杂志,2021,42(2):255-257.
[4] 宗宝宪,张培楠,郑雨,等.等离子低温射频消融术联合术中牵引治疗颈椎间盘突出症的临床研究[J].颈腰痛杂志,2019,40(4):486-488.
[5] YANG B,XIE J K,YIN B,et al.Treatment of cervical disc herniation through percutaneous minimally invasive techniques[J].Eur Spine J,2014,23(2):382-388.
[6] 李春根,柳根哲,徐林,等.经皮激光椎间盘减压术治疗颈椎椎间盘突出症[J].中国骨伤,2008,21(3):216-217.
[7] CHEN Y C,LEE S H,SAENZ Y,et al.Histologic findings of disc,end plate and neural elements after coblation of nucleus pulposus:an experimental nucleoplasty study[J].Spine J,2003,3(6):466-470.
[8] 张文秀,彭文娟,童迅,等.低温等离子术治疗颈椎间盘突出症100例[J].中国中医骨伤科杂志,2020,28(1):69-70.
[9] 陈广林,冯婷婷,徐世涛,等.低温等离子髓核成形术治疗神经根型颈椎病的临床观察[J].中国骨伤,2018,31(8):729-734.
[10] KIM M K,SIM S E,KIMY C,et al.Predictive factors of successful percutaneous cervical nucleoplasty for the treatment of pain with cervical herniated disk[J].World Neurosurg,2018,114:e654-e662.
[11] 李春根,江泽辉,李鹏洋,等.低温等离子髓核消融术治疗神经根型颈椎病的中期临床疗效观察[J].中国微创外科杂志,2017,17(5):402-406.
[12] DE ROOIJ J D,GADJRADJ P S,AUKES H,et al.Long-term clinical results of percutaneous cervical nucleoplasty for cervical radicular pain:a retrospective cohort study[J].J Pain Res,2022,17(15):1433-1441.
[13] 何升华,赖居易,王业广,等.低温等离子髓核射频消融术治疗颈椎病的疗效及并发症分析[J].中国中医骨伤科杂志,2017,25(3):43-45.
[14] 孙新立,周非非,孙宇,等.颈椎前路微创手术后再次翻修手术的原因分析[J].中国微创外科杂志,2021,21(3):226-230.
[15] 彭宝淦,杨亮.颈性头晕的发病机制[J].武警医学,2017,28(5):433-436.
[16] 庞晓东,吕裕霞,吴兵,等.低温等离子射频消融治疗下颈椎椎间盘源性眩晕的疗效[J].武警医学,2021,32(1):22-25.
[17] ALAHMARI K A,REDDY R S,SILVIAN P,et al.Influence of chronic neck pain on cervical joint position error(JPE):comparison between young and elderly subjects[J].J Back Musculoskelet Rehabil,2017,30(6):1265-1271.
[18] 李春根,江泽辉,李鹏洋,等.低温等离子髓核消融术治疗颈性眩晕近期临床疗效观察[J].中国脊柱脊髓杂志,2016,26(4):323-328.
[19] LI S F,CHEN R Q,CHEN Y Y,et al.Therapeutic effects and safety of percutaneous disc decompression with coblation nucleoplasty in cervical vertigo:a retrospective outcome study with 74 consecutive patients and minimum 1-year follow-up[J].Pain Physician,2019,22(3):E205-E214.
[20] LI C G,QI Y N,LIU G Z,et al.Long-term clinical outcomes of percutaneous cervical nucleoplasty for cervical degenerative diseases with neck pain and cervical vertigo[J].World Neurosurg,2020,133:e205-e210.

更新日期/Last Update: 2023-05-10