CT引导内镜后外侧入路腹侧减压治疗单节段脊髓型颈椎病疗效对比研究  

Study on single-level cervical spondylotic myelopathy treated by CT-guided posterolateral full-endoscopic ventral decompression

作　　者：王建 宗毅 陈榕 冉兵[2,3,4] 杨俊 付敏[2,3,4] 钟琼 陈新荣[2,3,4] 温新院 魏俊[2,3,4] WANG Jian;ZONG Yi;CHEN Rong;RAN Bing;YANG Jun;FU Min;ZHONG Qiong;CHEN Xin-rong;WEN Xin-yuan;WEI Jun(Gannan Medical University;Pain Department,the First Affiliated Hospital of Gannan Medical University;Pain Medical Institution of Gannan Medical University;Ganzhou Pain Medical Engineering And Technology Research Center,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院 [2]赣南医学院第一附属医院疼痛科 [3]赣南医学院疼痛医学研究所 [4]赣州市疼痛医学工程技术研究中心,江西赣州341000

出　　处：《赣南医学院学报》2021年第1期50-56,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨CT引导内镜下后外侧入路腹侧减压术(Posterolateral full-endoscopic ventral decompression,PLEVD)治疗单节段脊髓型颈椎病(Cervical spondylotic myelopathy,CSM)的安全性和有效性。方法:研究2018年1月—2020年1月收治的单节段脊髓型颈椎病患者67例,根据手术方法分为内镜组(PLEVD组)及开放组(ADF组),比较两组患者术前、术后1周、1月、3月及6月VAS评分和JOA评分,术后6月JOA改善率评估手术治疗效果,记录手术时间、住院时间、住院总费用及手术并发症情况。结果:两组患者术前、术后VAS评分除术后1周外各观察期差异无统计学意义(P>0.05),JOA评分比较差异无统计学意义(P>0.05),术后6月内镜组和开放组疗效优良率分别为90.63%、88.57%。结论:CT引导下PLEVD治疗单节段CSM是一种安全、有效的微创手术方式,值得进一步探讨。Objective:To investigate the safety,feasibility,and efficacy of posterolateral full-endoscopic ventral decompression(PLEVD)via computed tomography(CT)-guided surgery in patients with cervical spondylotic myelopathy(CSM).Methods:From January 2018 to January 2020,67 cases of single segment spondylotic myelopathy were divided into endoscopic and open group according to the operation method.To evaluate the surgical treatment effect,comparison was done between the two group patients with the visual analogue scal(VAS)score and japanese orthopaedic association(JOA)score pre-operatively and post-operatively(postoperative 1 weeks,1 month,3 months and 6 months),respectively,also JOA recovery rate at six months after operation.The operation time,length of hospital stay,total hospitalization expenses and surgical complications were also recorded.Results:There was no significant difference in VAS scores before and after surgery between the two groups except 1 week after surgery(P>0.05),and there was no significant difference in JOAscores between the two groups(P>0.05).The excellent and good efficacy rates of endoscopy group and open group 6 months after surgery were 90.63%and 88.57%,respectively.Conclusion:CT-guided PLEVD treatment of single-segment CSM is a safe and effective minimally invasive surgical method worthy of further study.

关 键 词：脊髓型颈椎病 脊柱内镜 后外侧入路腹侧减压术 微创 

分 类 号：R681.5[医药卫生—骨科学]