经后路摘除后外侧型颈椎间盘突出的疗效与安全性评价  

Posteolateral cervical disc herniation discectomy via posterior approach: efficiency and safety evaluation

作　　者：封亚平[1] 章翔[2] 封雨[1] 章薇[2] 唐少锋[1] 艾卫兵[1] 谢佳芯[1] 

机构地区：[1]成都军区昆明总医院全军脊髓损伤治疗中心,云南昆明650032 [2]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2015年第1期41-44,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：全军临床高新技术重大项目资助项目(01 MB039)

摘　　要：目的探讨后外侧型颈椎间盘突出采取后路手术切除髓核、并行颈椎侧块螺钉固定术的指征、疗效与安全性。方法自2006年10月至2012年12月我们收治了35例颈椎间盘外侧型突出、经颈后路手术切除椎间盘并行颈椎侧块螺钉内固定术进行回顾性研究。术后全组病例平均随访期为12个月,评价两项指标包括神经功能障碍和疼痛的改善状况。结果本组病例均采用日本骨科协会治疗评价分数(Japanese Orthopaedic Association Scores,JOAS),并比较手术前、后神经功能的变化情况。JOAS在术后为(14.35±1.65)分,与术前(6.82±2.36)分比较,经统计学分析有显著相差性(P<0.001)。术后神经功能平均改善率为87%,28例疼痛完全消失,7例明显好转。肌力及腱反射29例显著改善,6例有改善,无1例发生并发症。结论后外侧颈椎间盘突出行后入路髓核摘除术,是一种安全、有效的技术方法,对病损节段颈椎行侧块螺钉固定术,具有保护脊柱功能、重建其稳定性并防止术后椎间盘突出复发的良好作用。Objective The indication,safety and validity of intervertebral discectomy via posterior approach are investigated. Methods A total of 35 cases of lateral cervical disc herniation which underwent cervical disc discectomy via posterior approach and cervical lateral mass screw fixation from October 2006 to December 2012 were studied retrospectively. The mean post-operative follow-up period for all patients was 12 months. The evaluation indices included the situation of the neurological dysfunction and improvement of pain. Results All the cases were evaluated according to Japanese Orthopaedic Association Scores（ JOAS） and the neural functions were compared before and after operation. There was significant statistical difference in the JOAS of neural functions between preoperation and post-operation,respectively（ P〈0. 001）. The average improvement rate of neural function was 87%,including 28 cases of complete pain disappearance and 7 cases of obvious improvement. Muscle strength and tendon reflex were improved evidently in 29 cases,little improved in 6 cases and no case with complications. Conclusion The nucleus pulposus removal via posterior approach is a safe and effective treatment for posterolateral cervical intervertebral disc herniation. Lateral mass screw fixation can protect the functions of spine and prevent the postoperative recurrence of intervertebral disc herniation.

关 键 词：颈椎间盘突出 颈后路 髓核摘除术 脊柱稳定性重建 神经外科 

分 类 号：R681.53[医药卫生—骨科学]