等离子刀间盘消融术联合椎前病灶注射治疗混合型颈椎病

PERCUTANEOUS DISC DECOMPRESSION USING COBLATION TECHNIQUE WITH INJECTION OF ANTEROSPINAL LESION STRUCTURES FOR THE TREATMENT OF MIXED-TYPE CERVICAL DEGENERATIVE DISC DISEASE

目的：探讨应用等离子刀椎间盘消融术联合术中椎前病灶局部注射治疗混合型颈椎病的临床效果。方法：2005年10月～2006年10月采用经皮穿刺等离子刀间盘消融同期椎前病灶（颈前交感神经、钩椎关节、椎动脉前方和椎间孔处）注射组合药液治疗混合型颈椎病26例（53个椎间盘）。其中男12例、女14例。年龄48～81岁，平均58岁。结果：全部病例经皮穿刺颈椎间盘及椎前病灶注射顺利，未发生穿刺针管和刀头折断、大出血、大血肿和神经误伤等并发症。术后随诊6～18个月，采用Odom法评定疗效，优：10例，良：14例，可：2例，优良率92．3％。结论：等离子刀颈椎间盘消融术同时对椎间盘外的其它继发病变给予局部药物注射治疗，可以更加有效地消除混合型颈椎病的复杂病理因素。

Objective： To study the effect of percutaneous disc decompression using coblation technique in combination with injection of anterospinal lesion structures on mixed-type cervical disc disease. Method ： From October 2005 to October 2006, 26 patients （53 discs） were treated with percutaneous disc decompression using coblation technique in combination with injection of anterospinal lesion structures including anterospinal sympathetic nerve chains, Luschka joints, anterior space of vertebral arteries and intervertebral foramens. Of the 26 patients, 12 were male and 14 were female aging from 48 to 81 years with 58 on average. Result ： All the procedures underwent successfully without any complications such as breakage of spinal needle or coblation Catheter, severe bleeding, large hematoma and nerve root injury. Postoperative follow-up ranged from 6 to 18 months. According to Odom criteria, 10 were excellent, 14 were good and 2 were fair. The satisfactory rate was 92.3 %. Conclusion ： Percutaneous disc decompression using coblation technique with intraoperative injection of the extradiscal secondary lesion structures can further eliminate the complex pathogenic factors of mixed-type cervical degenerative disc disease.