经颈椎间孔硬膜外侧前间隙穿刺胶原酶注射治疗颈椎间盘突出症

Collagenase injection through intervertebral foramina into the ventrilateral epidural space for cervical disc herniation

目的我们设计经颈椎间孔穿刺在硬膜外侧前间隙注射胶原酶,旨在为颈椎间盘化学溶解术寻找一条简捷安全有效的穿刺途径。方法颈椎间盘突出症典型根型颈椎病患者23例,在C形臂X线机定位下,穿刺针经椎间孔至硬膜外侧前间隙并经造影证实无误后注射胶原酶1 200 U／3 ml。结果本组病例全部穿刺成功,23例患者术后3日症状均获缓解,VAS评分为0～2,优良率为91．3％(21／23例),未出现并发症,随访19例,7～42个月,均为优、良。结论影像监视下经椎间孔硬膜外侧前间隙胶原酶注射是治疗颈椎间盘突出症的较好入路,定位精确、穿刺径路短、较为安全、效果可靠。

Objective To find a safer and more effective method for collagenase injection to treat the cervical disc herniation. Methods A total of 23 cases of cervical disc herniation were included. Collagenase injection through intervertebral foramina into the cervical ventrilateral epidural space was performed with the guidance of digital subtraction angiography （ DSA ）, in combination with cervical spine computed radiography and magnetic resonance imaging. Results Satisfactory results were achieved in 100% of the cases using the method, without complication. The symptoms were alleviated three days after injection, VAS 0-2, in which the excellent and good rates were 91.3 % （ 21/23 cases）. The effects in 19 patients followed up 7-42 months were excellent and good. Conclusion Collagenase injection through intervertebral foramina into the ventrilateral epidural space with the guidance of DSA is a more accurate, safer, and more effective method for the treatment of cervical disc herniation.