后路经皮脊柱内镜下手术治疗神经根型颈椎病

Posterior percutaneous spinal endoscopic surgery for cervical spondylotic radiculopathy

目的探讨后路经皮脊柱内镜下椎间盘髓核摘除术治疗神经根型颈椎病的临床疗效。方法采用后路经皮脊柱内镜下椎间盘髓核摘除术治疗41例神经根型颈椎病患者。记录疼痛VAS评分、NDI及并发症发生情况,采用改良MacNab标准评价临床疗效。结果患者均获得随访,时间12~25个月。切口均一期愈合,未出现感染、硬膜囊撕裂、颈脊髓损伤及颈椎不稳等严重并发症,无翻修手术者。疼痛VAS评分及NDI:术后1 d及1、6、12个月均较术前降低(P<0.05)。术后1年采用改良MacNab标准进行疗效评价:优14例,良24例,可3例,优良率92.7%(38/41)。结论后路经皮脊柱内镜下椎间盘髓核摘除术可有效改善神经根型颈椎病症状,是一种安全、有效的微创手术方式,早期疗效可靠。

Objective To investigate the clinical efficacy of posterior percutaneous endoscopic discectomy in the treatment of cervical spondylotic radiculopathy.Methods The 41 patients with cervical spondylotic radiculopathy were treated by posterior percutaneous endoscopic discectomy.The pain VAS,neck disability index(NDI)and complications were recorded,and the clinical efficacy was evaluated with modified MacNab criterion.Results All patients were followed up for 12~25 months.All incisions healed in one-stage.No serious complications such as infection,dural sac tear,cervical spinal cord injuries or cervical instability occurred,and no patient required revision surgery.At 1 d,1,6,12 months postoperation,the pain VAS and NDI were both decreased than those before surgery(P<0.05).At 1 year postoperation,the efficacy was evaluated according to the modified MacNab criterion:excellent in 14 cases,good in 24,fair in 3,with an excellent-good rate of 92.7%(38/41).Conclusions Posterior percutaneous endoscopic cervical discectomy can effectively improve cervical spondylotic radiculopathy.It is a safe and effective,minimally invasive procedure,with possible early term.