改良后路法颈神经根阻滞术治疗神经根型颈椎病的临床研究

Clinical Study of Cervical Radiculopathy Treated by Modified Posterior Cervical Nerve Root Block

目的:探究改良后路法颈神经根阻滞术(Modified posterior cervical nerve root block,MPCNB)在治疗神经根型颈椎病治疗中的疗效和安全性。方法:收集自2019年6月至2022年3月我科室接受X线引导下MPCNB治疗的神经根型颈椎病患者37例,行回顾性分析。先记录患者术前的颈椎功能障碍指数(neck disability index,NDI)和疼痛视觉模拟量表(visual analogue scale,VAS)评分,患者接受MPCNB治疗后,记录其手术并发症情况,并在注射后的48小时、第6周及末次随访时间行NDI评分、VAS评分以及恢复优良率比较。结果:37例患者围术期轻微并发症发生率为5.40%;治疗后48小时、治疗后第6周、末次随访时37例患者的NDI评分、VAS评分与治疗前比较,差异有统计学意义(P<0.05);37例患者均完成MPCNB治疗,未出现重大或者永久性并发症;37例患者在治疗后48小时、治疗后第6周、末次随访时的恢复优良率均超过80%,但不同时间点恢复优良率比较,无差异(P>0.05)。结论:X线透视引导下改良后路法颈神经根阻滞术(MPCNB)是一种有效、高效而且安全的手术,能在极大程度上促使神经根型颈椎病患者恢复,缓解颈椎功能障碍及疼痛程度,值得推广。

Objective:To investigate the efficacy and safety of Modified posterior cervical nerve root block(MPCNB)in the treatment of cervical radiculopathy.Methods:From June 2019 to March 2022,37 patients with radicular cervical spondylosis receiving X-ray guided MPCNB treatment in our department were collected and analyzed retrospectively.Preoperative neck disability index(NDI)and visual analogue scale(VAS)scores were recorded,and postoperative complications were recorded after MPCNB treatment.NDI score,VAS score and recovery rate were compared at 48 hours after injection,6 weeks and the last follow-up time.Results:The incidence of perioperative minor complications in 37 patients was 5.40%.At 48 hours after treatment,6 weeks after treatment and the last follow-up,the NDI scores and VAS scores of 37 patients were significantly different from those before treatment(P<0.05).All the 37 patients completed MPCNB treatment without major or permanent complications.The recovery rate of 37 patients was more than 80%at 48 hours after treatment,6 weeks after treatment and the last follow-up,but there was no difference in the recovery rate at different time points(P>0.05).Conclusion:Modified posterior cervical nerve root block(MPCNB)under fluoroscopy guidance is an effective,efficient and safe operation,which can greatly promote the recovery of patients with cervical radiculopathy,relieve cervical spine dysfunction and pain,and is worth popularizing.