后路单侧减压固定治疗单节段神经根型颈椎病疗效分析  

Clinical Effects of Posterior Decompression Combined with Unilateral Fixation in Treatment of Single-segmentalcervical Spondylotic Radiculopathy

作　　者：普有登[1] 杨俊宇 周兆文[1] 段洪[1] 孙启增 金雄[1] PU You-deng;YANG Jun-yu;ZHOU Zhao-wen;DUAN Hong;SUN Qi-zeng;JIN Xiong(Dept.of Orthopedics,Calmette Hospital of Kunming First People’s Hospital,Kunming Yunnan 650000,China)

机构地区：[1]昆明市第一人民医院甘美医院骨科,云南昆明650000

出　　处：《昆明医科大学学报》2021年第2期75-80,共6页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2018FE001(-283)]。

摘　　要：目的探讨后路单侧减压固定治疗单节段神经根型颈椎病的初期临床疗效。方法回顾性分析昆明市第一人民医院甘美医院骨科自2016年1月至2018年12月收治的26例经后路单侧减压固定治疗的神经根型颈椎病患者的临床资料。其中,男16例,女10例,年龄39~62岁,平均50.5岁,手术节段C6/77例、C5/612例、C4/57例。评估手术时间、术中出血量,术前及末次随访时颈椎神经根性疼痛视觉模拟(VAS)评分,术前及末次随访时颈椎功能残障指数量表(NDI)评分、术后颈椎病疗效Odom评级、术后2 d及末次随访时颈椎椎间隙高度(DH)、手术并发症情况、术后影像学检查神经受压改善情况。结果26例患者均获得随访,随访16~25个月,平均(18.1±4.8)个月。平均手术时间(76.9±12.8)min;术中出血量(87.3±14.3)mL;术前根性疼痛VAS评分平均(6.9±0.8)分,术后末次随访时间根性疼痛VAS评分平均(1.4±0.6)分,术前与术后根性疼痛VAS评分比较,差异有统计学意义(P<0.05);术前NDI评分平均(32.4±4.3)分,末次随访时间NDI评分平均(16.3±6.7)分;术后2 d平均DH为(5.8±0.6)mm,末次随访平均DH为(5.7±0.4)mm,两者比较差异无统计学意义(P>0.05);术后颈椎病疗效Odom评级优8例(30.8%),良14例(53.8%),可4例(15.4%),优良率为84.6%。术后未出现感染、固定物松动、椎动脉损伤等并发症。结论经后路单侧减压固定治疗单节段神经根型颈椎病初期疗效良好,对于侧方椎间盘突出并有神经根管狭窄的神经根型颈椎病,可以作为除前路手术外的另一选择。Objective To explore the initial clinical effect of posterior unilateral decompression and fixation for single-segment cervical spondylosis.Methods We retrospectively analyzed the clinical data of 26 patients with cervical spondylotic radiculopathy treated by unilateral decompression and fixation by posterior approach from January 2016 to December 2018.Among them,there were 16 males and 10 females,aged 39-62 years old,with an average age of 50.5 years.The surgical segment included 7 cases in C6/7,12 cases in C5/6,and 7 cases in C4/5.Then we evaluated the operation time,intraoperative blood loss,visual analogue(VAS)score of cervical radiculopathy before operation and last follow-up,cervical spine functional disability index(NDI)score before operation and last follow-up,and Odom rating of postoperative cervical spondylopathy,2 days after operation and at the last follow-up,the height of the cervical intervertebral space(DH),surgical complications,and the improvement of postoperative imaging examination of nerve compression.Results All 26 patients were followed up for 16-25 months,with an average of(18.1±4.8)months.The average operation time was(76.9±12.8)min;intraoperative blood loss was(87.3±14.3)mL;average preoperative radicular pain VAS score was(6.9±0.8)points,average postoperative radicular pain VAS score was(1.4±0.6).There were significant differences in radicular pain VAS scores between the preoperation and postoperation(P<0.05);the preoperative NDI score was(32.4±4.3)points,and(16.3±6.7)points at the last follow-up.After operation 2 days,the DH average was(5.8±0.6)mm,and(5.7±0.4)mm at the last follow-up.There was no statistically significant difference between the two groups(P>0.05).The postoperative cervical spondylosis efficacy Odom rating was excellent in 8 cases(30.8%),14 cases were good(53.8%),4 cases were fair(15.4%),and the excellent and good rate was 84.6%.There were no complications such as infection,internal fixation loose,and vertebral artery injury.Conclusions The posterior unilateral d

关 键 词：神经根型颈椎病 后路减压 内固定 椎弓根钉 单节段 

分 类 号：R681.55[医药卫生—骨科学]