经皮激光椎间盘减压术治疗颈性眩晕的远期疗效观察

Observation of long-term efficacy of percutaneous laser disc decompression in treatment of cervical vertigo

(1)目的观察经皮激光椎间盘减压术(percutaneous laser disc decompression,PLDD)治疗颈性眩晕的远期疗效,分析性别、年龄、治疗椎间隙数量等因素对疗效的影响,为临床治疗颈性眩晕提供一种疗效实用、可靠、稳定的方法。(2)方法对PLDD治疗的颈性眩晕患者进行随访,应用数字评分法(NRS)评价、改良Macnab评价标准分别对眩晕及伴随症状、临床疗效进行综合评估,并对入组患者按照治疗间隙数量(单间隙、非单间隙组)、性别(男性组、女性组)、年龄(中青年组、老年组,即≤65岁组、>65岁组)分组比较,进行统计学分析。(3)结果最终入组患者28例(男10例,女18例),平均年龄59.82岁(47~83岁),平均随访(101.71±5.37)个月(90~152个月)。PLDD治疗颈性眩晕总体优良率为60.71%,有效率为85.71%。手术治疗单间隙组与非单间隙组间的优良率分别为60.00%、61.11%,有效率分别为80.00%、88.89%,统计学比较无明显差异(P>0.05);老年组与中青年组的优良率分别为61.54%、60.00%,有效率分别为84.62%、86.67%,不同年龄组间优良率、有效率的比较均无明显差异性(P>0.05);男性组与女性组的优良率分别为40.00%、72.22%,有效率分别为90.00%、83.33%,不同性别组间优良率、有效率的比较均无明显差异性(P>0.05)。(4)结论经皮激光椎间盘减压术治疗颈性眩晕远期疗效与治疗椎间隙数量、性别、年龄不相关,均能获得令人满意的远期疗效。

Objective To observe the long-term efficacy of percutaneous laser disc decompression （PLDD） for the treatment of cervical vertigo（CV）.Methods All patients were treated with PLDD by the Nd： YAG laser therapy and were foliowed up.The improvement of vertigo and its characteristics was evaluated by numerical rating scale （NRS） assessment,and fineness rate and efficient rate were evaluated using modified MacNab assessment criteria.And the patients in the group according to gender （male group and female group） ,age （less than 65 years old,more than 65 year old group） group,number of operative intervertebral spaces （single gap,non-single gap） the clinical curative effect of the data were collected for group comparison and statistical analysis.Results No intraoperative and postopera- tive complication was reported. 28 patients with complete data were admitted at last,, including 10 males and 18 females, aged between 47 and 83 years with an average of 59.82 years.The patients were followed up for 90-152 months with a mean of（101.71±5.37）moUnths,At the latest follow-up,the average NRS scores of the dizziness and its characteristics are significantly smaller. The overall efficacy was evaluated based on modified MacNab criteria： excellent, 11cases; good, 6cases ; acceptable, 7cases ; and poor, 4 cases. Overall excellent and good rate was 60.71% the total effective rate was 85.71%. The age group of 〉65 and group of patients ≤65 years, the excellent and good rate was 84.62% and 86.67%,respectively 61.54%and 60.00%.There was no significant difference between the two groups （ P 〉0.05）.Male and female groups were compared,the excellent and good rate was 40% and 72.22%. respectively, 90% and 83.33 % respectively.There is no statistical difference existed between age groups f （ P 〉0.05）and also between gender groups （ P 〉0.05）.Conclusion PLDD for the treatment of cervical vertigo does has a better and satisfactory long-term efficacy with no significant difference in clinical efficacy between different age and gender groups.