颈椎间盘切除及椎间孔减压术治疗神经根型颈椎病

Cervical discectomy and intervertebral foramen decompression in treatment of cervical spondylotic radiculopathy

目的探讨颈椎间盘切除及椎间孔减压治疗神经根型颈椎病的方法与效果。方法自2007年2月～2010年4月对21例神经根型颈椎病行颈椎间盘切除及椎间孔减压、椎间cage植骨、钛板内固定术。按照VAS、NDI评分及融合节段的影像学资料分别对患者治疗前后疼痛的程度、日常生活的影响及颈椎曲度的改变进行疗效评判。结果 17例获得随访,平均19个月。术中均未出现椎动脉损伤、神经根损伤及硬膜破裂的情况。所有患者随访期间均达到骨性融合,钢板无松动。术后1周、终末随访时,VAS、NDI和融合节段曲度较术前均有明显改善(P<0.05)。终末随访与术后1周比较,VAS和融合节段曲度比较,差异无统计学意义(P>0.05),而NDI比较差异有统计学意义(P<0.05)。结论颈椎间盘切除及椎间孔减压术治疗神经根型颈椎病疗效可靠,减压彻底,术中应避免损伤椎动脉。

Objective To explore the method and effects of cervical discectomy and intervertebral foramen decompression in treating cervical spondylotic radiculopathy. Methods From February 2007 to April 2010, 21 patients with cervical spondylotic radiculopathy were treated with cervical discectomy, intervertebral foramen decompression, intervertebral body cage bone graft, internal fixation with titanium plate. The degree of pain, condition of daily life and change of cervical curvature were evaluated before and after treatment according to VAS, NDI and X-ray data. Results Seventeen cases were followed up with an average time of 19 months. No injury of vertebral artery, injury of nerve root, rupture of dura were found during operation. All patients obtained bone fusion and had no plate loosening. VAS, NDI and fusion curvature improved obviously at the 1 week after operation and final follow-up. There were no significant differences in VAS and fusion curvature between postoperative 1 week and final follow-up, but there was significant difference in NDI. Conclusion Cervical discectomy and intervertebral foramen decompression can obtain reliable effect in treating cervicalspondylotic radiculopathy, and it can achieve thorough decompression and should avoid injury of vertebral artery on surgical treatment.