后路脊柱内镜椎板开窗联合神经减压手术治疗神经根型颈椎病

Posterior spinal endoscopic lamina fenestration combined with nerve decompression for the treatment of cervical spondylotic radiculopathy

目的探讨后路脊柱内镜椎板开窗联合神经减压手术治疗神经根型颈椎病的疗效。方法采用后路脊柱内镜椎板开窗联合神经减压手术治疗35例神经根型颈椎病患者。记录术中出血量、手术时间、并发症发生情况、疼痛VAS评分。采用改良MacNab标准评价疗效。结果患者均获得随访,时间3~7个月。术中出血量10~25(16.94±5.08)ml,手术时间70~138(89.58±11.27)min。术中未出现硬脊膜撕裂情况;术后无神经根、颈髓、椎动脉损伤及椎间隙感染等并发症发生。疼痛VAS评分术后各时间点均较术前降低(P<0.05)。末次随访时采用改良MacNab标准评价疗效:优27例,良7例,可1例,优良率97.14%(34/35)。结论后路脊柱内镜椎板开窗联合神经减压手术治疗神经根型颈椎病,微创、安全、疗效可靠。

Objective To investigate the clinical efficacy of posterior spinal endoscopic lamina fenestration combined with nerve decompression for treatment of cervical spondylotic radiculopathy.Methods The 35 cases of cervical spondylotic radiculopathy were received the posterior spinal endoscopic lamina fenestration combined with nerve decompression.The intraoperative blood loss,operation time,complication and pain VAS were recorded.Clinical efficacy was assessed by the modified MacNab criteria.Results All patients were followed up for 3~7 months.The intraoperative blood loss was 10~25(16.94±5.08)ml,the operation time was 70~138(89.58±11.27)min.There were no intraoperative dural tears.No perioperative complications such as injuries of the nerve root,cervical cord,vertebral artery,or intervertebral space infection occurred.The pain VAS at each time-point after operation were decreased than those before operation(P<0.05).At the last follow-up,the effect was assessed with the improved MacNab criteria,the result was excellent in 27 cases,good in 7 cases,fair 1 case,the excellent-good rate was 97.14%(34/35).Conclusions Posterior spinal endoscopic lamina fenestration combined with nerve decompressionin for treatment of cervical spondylotic radiculopathy is minimal invasive,safe,and which have relibable efficacy.