椎间盘镜下经肌间隙入路治疗多节段脊髓型颈椎病的安全性和有效性分析

Safety and Effectiveness Analysis of Paraspinal Muscle Approach With Microendoscopy for Multilevel Cervical Spondylotic Myelopathy

目的研究椎间盘镜下经肌间隙入路治疗多节段脊髓型颈椎病的安全性和有效性,为临床合理选择治疗方案提供参考依据。方法连续选择首次诊断并接受手术治疗的多节段脊髓型颈椎病患者共40例,随机分为对照组和观察组各20例,对照组采用颈3~7后路单开门椎管扩大成形术,观察组采用椎间盘镜下经肌间隙入路,对比治疗效果。结果两组的手术时间无统计学差异,观察组术中出血量、术后住院时间及术后引流量明显减少,术后1 d、7 d和14 d VAS评分降低,JOA评分改善率中优良率增加,并发症减少,差异均有统计学意义(P<0.05)。结论椎间盘镜下经肌间隙入路治疗多节段脊髓型颈椎病有较好的安全性和有效性,值得临床应用推广。

Objective To study the safety and effectiveness of paraspinal muscle approach with microendoscopy for multilevel cervical spondylotic myelopathy（MCSM）.nethods A total of 40 consecutives were divided randomly into control and observation groups and each of 20 cases.The patients in control group received cervical 3~7 posterior single open door laminoplasty, and the others in ob- servation group received paraspinal muscle approach with microendoscopy.Then to compare the difference.Results The operation time in the two groups were no statistical difference, however, the blood bloss during operation, stay-in hospital time and drainage volume after operation in observation group were all significantly lower;the VAS value after lday,7days and 14days were all less; excellent rate of JOA score improvement rate was higher;complications rate was lower （P〈0.05）.Conclusion Paraspinal muscle approach with microendoscopy for multilevel cervical spondylotic myelopathy has better safety and effectiveness.