颈椎间盘突出症介入治疗的现状和进展

Interventional therapy of cervical disc herniation:its current situation and progress

颈椎间盘突出症(CDH)临床上较为常见,多发于中老年人,表现为头、颈、肩及上肢的疼痛或麻木感,可伴有下肢的行走无力及步态不稳,随着病情的进展,可导致患者大小便功能障碍,使患者的生活质量降低。近年来随着介入技术的发展,其已成为治疗CDH的趋势,介入治疗因其具有损伤小、恢复快、疗效好等优点,易被多数医患接受。现阶段常用的微创介入治疗措施主要有经皮激光椎间盘减压术(PLDD)、髓核化学溶解术、臭氧(O3)髓核溶解术、射频热凝靶点消融术、低温等离子射频消融术、经皮内镜颈椎间盘切除术(PECD)以及经皮穿刺颈椎间盘髓核切除术(PCD),可根据患者的病情以及需求选择相应的微创介入方式,本文就这7种介入治疗方式的临床应用及研究现状加以综述,为临床工作提供参考。

Clinically,cervical disc herniation(CDH)is a common disease,which is more common among middle-aged and elderly people.CDH is characterized by pain or numbness in the head,neck,shoulders and upper limbs,which can be accompanied with walking weakness of lower limbs and instability of gait.With the progress of the disease,the patients may develop dysfunction of defecation and urine,making the quality of life worse.With the development of interventional technology in recent years,the use of intervention therapy has become a trend for the treatment of CDH.Because of its advantages of less injury,quick recovery and satisfactory curative effect,the interventional therapy is easily accepted by most physicians and patients.At present,the most commonly used minimally-invasive interventional treatments mainly include percutaneous laser disc decompression(PLDD),chemonucleolysis,ozone(O3)nucleus pulposus lysis,radiofrequency thermocoagulation target ablation,low temperature plasma radiofrequency ablation,percutaneous endoscopic cervical discectomy(PECD)and percutaneous discectomy(PCD).According to the patient’s condition and needs,the appropriate minimally-invasive interventional therapy can be selected.This paper aims to make a comprehensive review about the clinical application and research status of the above-mentioned seven interventional treatments so as to provide reference for clinical practice.