后路经皮内窥镜下颈椎间盘切除术在神经根型颈椎病患者中的实施效果

Effect of Posterior Percutaneous Endoscopic Cervical Discectomy in Patients with Cervical Spondylotic Radiculopathy

目的分析后路经皮内窥镜下颈椎间盘切除术在神经根型颈椎病中的实施效果。方法采用回顾分析法,选择2018年1月至2019年12月于信阳市第四人民医院就诊的85例神经根型颈椎病患者,按不同手术方法分为两组,即前路组40例[前路减压椎间植骨融合内固定手术(ACDF)]和后路组45例[后路经皮内窥镜下颈椎间盘切除术(PPECD)]。比较两组术后颈椎功能障碍改善情况、两组术后治疗效果、两组颈椎活动度、两组术后疼痛程度、两组神经系统功能、两组患者颈动脉血流速度、两组并发症发生情况。结果两组术后优良率比较,差异无统计学意义(P>0.05)。后路组术后12个月颈椎功能障碍指数(NDI)低于前路组,颈椎的Cobb角及屈伸活动度高于前路组,差异有统计学意义(P<0.05)。后路组术后12个月的颈椎、上肢疼痛程度低于前路组,颈椎功能、下腰痛评分低于前路组,差异有统计学意义(P<0.05)。后路组术后12个月颈动脉收缩峰值血流速度、平均血流速度明显高于前路组,差异有统计学意义(P<0.05)。后路组并发症发生率低于前路组,差异有统计学意义(P<0.05)。结论后路经皮内窥镜下颈椎间盘切除术创伤小,可作为神经根型颈椎病的理想手术。

Objective To analyze the effect of posterior percutaneous endoscopic cervical discectomy in cervical spondylotic radiculopathy.Methods Retrospective analysis 85 patients with cervical spondylotic radiculopathy admitted to Xinyang Fourth People's Hospital of Pingqiao District,Xinyang City,Henan Province from January 2018 to December 2019 were divided into two groups according to different surgical methods,namely the anterior group of 40 cases[anterior decompression and interbody fusion internal fixation surgery(ACDF)]and the posterior group of 45 cases[posterior percutaneous endoscopic cervical discectomy(PPECD)].Postoperative improvement of cervical dysfunction,postoperative therapeutic effect,cervical motion,postoperative pain,nervous system function,carotid blood flow velocity and complications were compared between the two groups.Results There was no significant difference in the excellent and good rate between the two groups after operation(P>0.05).The cervical dysfunction index(NDI)in the posterior group was lower than that in the anterior group 12 months after operation,the Cobb angle and flexion-extension activity of the cervical spine were higher than those in the anterior group,the difference was statistically significant(P<0.05).The pain degree of cervical vertebrae and upper limbs in the posterior group was lower than that in the anterior group at 12 months after operation,and the scores of cervical vertebrae function and lower back pain were lower than those in the anterior group,the difference was statistically significant(P<0.05).The peak blood flow velocity and average blood flow velocity of carotid artery contraction in the posterior group were significantly higher than those in the anterior group at 12 months after surgery,with statistical significance(P<0.05).The complication rate of the posterior approach group was lower than that of the anterior approach group,and the difference was statistically significant(P<0.05).Conclusion Posterior percutaneous endoscopic cervical discectomy has less trauma and can be used as an ideal operation for cervical spondylotic radiculopathy.