自控硬膜外镇痛配合针刀闭合松解术治疗颈椎间盘突出所致神经根型颈椎病

Treatment of patient controlled epidural analgesia(PCEA) and needle scalpel close loosening therapy to cervical spondylotic radiculopathy(CSR) by cervical vertebra disk hernitation

目的探讨自控硬膜外镇痛(PCEA)配合针刀闭合松解术治疗颈椎间盘突出所致神经根型颈椎病的临床疗效。方法颈椎间盘突出症所致神经根型颈椎病38例,除外颈椎间盘突出所致脊髓型颈椎病,除外非颈椎间盘突出所致的神经根型颈椎病,排除PCEA和针刀治疗禁忌证患者。于C6～7或C7～T1椎间隙行PCEA,第2～3天行针刀闭合松解术,并进行日常生活指导。结果根据Macnab疗效标准,在治疗1、2周,1、3、6、12个月进行疗效评级,优良率分别为78.9%、89.5%、89.5%、84.2%、78.9%和76.3%。结论采用PCEA配合针刀闭合松解术治疗颈椎间盘突出所致神经根型颈椎病,具有良好的近中期疗效。

Objective To discuss the treatment of patient controlled epidural analgesia（PCEA） and needle scalpel close loosening therapy to cervical spondylotic radiculopathy（CSR） by cervical vertebra disk hernitation.Methods Forty cases of CSR by cervical vertebra disk hernitation.except CSR not by cervical vertebra disk hernitation and cervical spondylotic myelopathy were treated by PCEA through C6～7 or C7～T1 and needle scalpel close loosening therapy after 2～3 days.They were all suggested living guidance.Results According Macnab curative effect,excellent rate were 78.9%、89.5%、89.5%、84.2%、78.9% and 76.3% in first and twice week,first third sixth and twelfth month after treatment.Conclusion There were right curative effect of PECA and needle scalpel close loosening therapy to CSR in the near and middle future.