钥匙孔技术在神经根型颈椎病治疗中应用的效果

Comparison of Key-Hole Technique on the Treatment of Cervical Spondylotic Radiculopathy

目的:经皮后路脊柱内镜下钥匙孔(Key-hole)技术在神经根型颈椎病(CSR)治疗中应用的效果。方法:回顾性分析2021年6月至2022年6月行经皮后路脊柱内镜下钥匙孔术的43例神经根型颈椎病患者的资料,记录手术疗效评价指标,判定术后6个月疗效,测定术前、术后1个月、3个月及6个月Cobb角,并评定疼痛数字分级法(NRS)评分、神经根型颈椎病症状与功能评定量表评分、颈椎功能障碍指数(NDI)。结果:43例患者均成功完成钥匙孔术,手术用时为(71.36±11.31)min,切口长度为(0.74±0.23)cm,术中失血量为(34.79±6.78)mL,住院时间为(6.81±1.28)d;术后仅有1例患者出现四肢麻木症状,短期内好转。术后1个月、3个月及6个月随访发现,患者数字评分法及功能障碍指数评分均较术前明显降低,差异有统计学意义(P<0.05);症状功能评分均较术前明显增高,差异有统计学意义(P<0.05);Cobb角均较术前明显增大,差异有统计学意义(P<0.05)。结论:经皮后路脊柱内镜下钥匙孔手术对神经根型颈椎病患者疼痛、症状及功能障碍的改善效果较好,且具有切口小、术后恢复快等微创优势。

Objective:To compare the efficacy of posterior endoscopic Key-hole technique on the treatment of cervical spondylotic radiculopathy(CSR).Methods:43 patients undergoing percutaneous posterior spinal endoscopic Key-hole surgery from June 2021 to June 2022 were analyzed retrospectively.The surgical indicators were recorded,the postoperative efficacy was determined at 6 months,the Cobb angle was measured at 1,3 and 6 months before and after surgery,the pain numerical rating scale(NRS)score,CSR symptom and function assessment scale score,and neck disability index(NDI)were evaluated.Results:All 43 patients successfully completed Key-hole surgery,with surgical time of(71.36±11.31)min,incision length of(0.74±0.23)cm,intraoperative blood loss of(34.79±6.78)mL,and hospital stay of(6.81±1.28)d.Only one patient experienced limb numbness after surgery,which could improve in the short term.At 1,3 and 6 months follow-up after surgery,the patient's NRS and NDI scores were significantly reduced compared to before surgery(P<0.05),the symptom function score was significantly increased compared to before surgery(P<0.05),and the Cobb angle was significantly increased compared to before surgery(P<0.05).Conclusion:Key-hole surgery under percutaneous posterior spine endoscopy has a good efficacy on the improvement of pain,symptoms and dysfunction in patients with CSR,and has the advantages of small incision and quick postoperative recovery.