前路经皮内窥镜下颈椎间盘髓核摘除术的临床应用  

Clinical application of anterior percutaneous endoscopic cervical discectomy

作　　者：柯珍勇[1] 楚磊[1] 陈富[1] 程昀[1] KaixuanLiu 邓忠良[1] 

机构地区：[1]重庆医科大学附属第二医院骨科,400010 [2]Atlantic Spinal Care, LLC., 1921 Oak Tree Rd, Edison, N J, USA08820

出　　处：《中华创伤杂志》2013年第7期602-607,共6页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目（81272005）;国家自然科学基金资助项目（31000434）;重庆市卫生局重点课题资助项目（2011-1-053）

摘　　要：目的探讨前路经皮内窥镜下颈椎间盘髓核摘除术（percutanousendoscopiccervicaldiscectomy，PECD）的安全性、可行性及临床疗效。方法选择用PECD治疗的28例患者。术前及术后3d、1，3，6，12及18个月分别行视觉模拟评分（visualanaloguescale，VAS）及MacNab评分。术后1，3及12个月行MRI检查。所有评分数据收集后使用SAS软件进行单因素丁检验分析。结果25例患者获得随访18～24个月，平均19个月。术后3dVAS和MacNab评分较术前改善（P〉0．05），术后1，3，6，12及18个月VAS和MacNab评分较术前明显改善（P〈0．01）；术后3d与术后3，6，12及18个月VAS和MacNab评分比较，差异有统计学意义（P〈0．05）；术后1，3，6。12及18个月VAS和MacNab评分比较差异无统计学意义（P〉0．05）。术后24个月VAS评分及MacNab评分较术前改善明显（P〈0．01），较术后3d明显改善（P〈0．01）。结论前路PECD对软组织性和部分骨性颈椎间盘突出具有良好的疗效。Objective To evaluate the safety, feasibility, and clinical outcome of anterior percu- taneous endoscopic cervical discectomy （PECD）. Methods The study involved 28 patients undergone PECD. Visual analogue scale （VAS） and MacNab scale were recorded before operation and at 3 days, 1 , 3, 6, 12 and 18 months after operation. In addition, MRI examination was conducted at postoperative 1 month, 3 months and 12 months. After data collection, single-factor T test with SAS software was per- formed. Results Follow-up （range, 18-24 months, mean 19 months ） was achieved in 25 patients. When compared to the preoperative score, VAS and MacNab scale presented improvement at postoperative 3 clays （P 〉 O. 05 ） and great improvement at postoperative 1, 3, 6, 12, 18 and 24 months （P 〈 0.01 ）. VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3, 6, 12 and 18 months （P 〈 0.05 ） , but the differences were not statistically insignificant at postoperative 3, 6, 12, and 18 months （P 〉0.05）. Moreover, VAS and MacNab scale showed signifi- cant improvement at postoperative 24 months as compared to those before operation （ P 〈 0.01 ） and those at postoperative day 3 （ P 〈 0.01 ）. Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.

关 键 词：脊柱损伤 颈椎 椎间盘 经皮内窥镜下颈椎间盘髓核摘除术 

分 类 号：R681.53[医药卫生—骨科学]