后路经皮内镜下颈椎间盘摘除术治疗外侧型颈椎间盘突出症  

Posterior percutaneous endoscopic cervical discectomy for lateral disc herniations

作　　者：刘观燚[1] 沈锋 胡利华 周雷杰[1] 廖旭昱[1] 韩金明[1] 马维虎[1] LIU Guan-yi;SHEN Feng;HU Li-hua;ZHOU Lei-jie;LIAO Xu-yu;HAN Jin-ming;MA Wei-hu(Department of Spine Surgery,Ningbo Sixth Hospital,Ningbo,Zhejiang 315040,China;不详)

机构地区：[1]宁波市第六医院脊柱外科,浙江315040 [2]宁波大学医学院

出　　处：《中国骨与关节损伤杂志》2021年第1期1-4,共4页Chinese Journal of Bone and Joint Injury

基　　金：浙江省新世纪151人才工程(201702);宁波市自然基金项目(2018A610259);浙江省医药卫生科技计划(2020RC110);浙江省公益技术研究计划(LGF20H060007)。

摘　　要：目的分析后路经皮内镜下颈椎间盘摘除术治疗外侧型颈椎间盘突出症的临床疗效。方法回顾性分析自2015-10—2018-01采用后路经皮内镜下颈椎间盘摘除术治疗的27例外侧型颈椎间盘突出症,比较术前与术后1、6、12个月疼痛VAS评分及NDI指数。结果 27例均顺利完成手术,随访时间24~41个月,平均29个月。手术时间67~210 min,平均80 min,住院时间2~10 d,平均3 d。1例术中出现硬脊膜撕裂,1例术后出现切口渗液,轻度红肿,发热,分泌物细菌培养阴性,对症处理后治愈。27例术后1 d上肢疼痛和颈部疼痛症状均有明显改善,25例术后1 d疼痛消失或者明显减轻,24例术后第1 d肌力得到明显改善。末次随访时5例手术节段椎间盘突出加重。27例术后1、6、12个月疼痛VAS评分与NDI评分较术前明显改善,差异有统计学意义(P<0.05),但术后1、6、12个月间疼痛VAS评分与NDI评分比较差异无统计学意义(P>0.05)。结论后路经皮内镜下颈椎间盘摘除术治疗外侧型颈椎间盘突出症安全有效,术后恢复快,值得临床推广。Objective To report the outcomes of posterior full-endoscopic cervical discectomy for lateral disc herniations.Methods Twenty-seven consecutive patients that underwent posterior full-endoscopic cervical discectomy with lateral disc herniations and cervical radiculopathy from October 2015 to January 2018 were included in this study.Clinical outcomes were assessed before surgery and at 1,6,and 12 months postoperatively using visual analogue scale for neck and arm and neck disability index(NDI)scores postoperatively.Results All patients underwent the surgery successfully.The follow-up time was 24 to 41 months,with an average of 29 months.The operation time was 67-210 minutes,with an average of 80 minutes,and the hospital stay was 2-10 days,with an average of 3 days.One patient suffered from dura mater damage and one patient had incision infection.The upper limb pain and neck pain symptoms of 27 cases were significantly improved on the first day after surgery.The pain disappeared or decreased significantly on the first day after surgery in 25 cases.The muscle strength of 24 cases was significantly improved on the first day after surgery.At the last follow-up,5 cases of intervertebral disc herniation at the operation segment worsened.The pain VAS score and NDI score of 27 patients at 1,6,and 12 months after surgery were significantly better than those before surgery,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in the pain VAS score and NDI score at 1,6,and 12 months after surgery(P>0.05).Conclusion Posterior percutaneous endoscopic cervical discectomy is safe and effective for the treatment of lateral cervical disc herniation,and the postoperative recovery is fast.It is worthy of clinical promotion.

关 键 词：经皮内镜下颈椎间盘摘除术 颈椎间盘突出症 后路入路手术 

分 类 号：R687.3[医药卫生—骨科学]