微创治疗颈椎间盘突出37例

Minimally-invasive interventional treatment for cervical disc herniation: initial experience in 37 patients

目的探讨经皮穿刺颈椎间盘髓核切除术(percutaneous cervical discectomy,PCD)联合低温等离子消融术(percutaneous nucleoplasty,PCN)治疗颈椎间盘突出的临床应用。方法在C型臂X线机引导下,选择颈部前外侧经气管、食管与颈动脉鞘之间入路,用穿刺针插入椎间盘中心,然后依次使用椎间盘旋切系统及等离子消融系统治疗颈椎间盘突出患者37例。结果治疗37例患者,1例手术失败,有效率为80.6%;1例等离子刀头断裂,但随访无后遗症。结论 PCD联合PCN治疗颈椎间盘突出具有创伤小、痛苦少、安全性高、恢复快等特点,是治疗颈椎间盘突出的有效方法之一。

Objective To discuss the clinical application of percutaneous cervical discectomy （PCD） combined with pereutaneous nucleoplasty （PCN） in treating cervical disc herniation. Methods Under C-arm fluoroscopic monitoring, the suitable access region between anterolateral cervical visceral sheath and carotid sheath for puncturing was selected, the puncture needle was inserted to the center of the corresponding cervical intervertebral disc. Then, PCD and PCN were carried out in tum to treat the cervical disc herniation in all 37 patients. Results PCD combined with PCN was successfully accomplished in 36 patients, and the procedure failed in one patient; the effective rate was 80.6%. Rupture of the head of plasma knife occurred in one patient, but no serious sequela was observed during the follow-up period. Conclusion PCD combined with PCN has certain advantages, such as less trauma, less pain, high safety, fast recovery and so on. Therefore, this technique is one of the effective methods for the treatment of cervical disc herniation.