超声引导颈椎间盘髓核消融术治疗颈椎病临床研究  

Clinical effect of ultrasound-guided radiofrequency ablation for cervical spondylosis

作　　者：向忠 何秀波[1] XIANG Zhong;HE Xiubo(Changsha Hospital of Hunan Normal University(the Fourth Hospital of Changsha),Changsha,Hunan 410006,China)

机构地区：[1]湖南师范大学附属长沙医院暨长沙市第四医院,湖南长沙410006

出　　处：《中国医学工程》2022年第4期55-58,共4页China Medical Engineering

基　　金：湖南省卫健委科研项目(B20182008)。

摘　　要：目的研究超声引导颈椎间盘穿刺等离子髓核消融术治疗颈椎病的方法和近期临床疗效。方法2016年5月至2021年5月共15例颈椎病患者行超声引导下经皮穿刺颈椎间盘低温等离子髓核射频消融术治疗。15例患者获得半年以上随访,其中神经根型颈椎病6例,脊髓型颈椎病3例,颈型颈椎病4例,混合型颈椎病2例。男2例,女13例,年龄36~72岁,平均(58±2)岁。采用视觉模拟评分法(VAS)、颈椎病颈性眩晕症状与功能评分表和改良Macnab疗效分级评分评价术后1周、术后1个月、术后3个月、术后6个月的疗效和有效率。结果所有患者B超引导下穿刺均获成功,术中即刻无血管、食管、神经等损伤。15例随访者中,术后未出现血肿、神经损伤、感染等并发症,术后1周、术后1个月、术后3个月、术后6个月VAS评分分别为(2.61±0.42)分、(2.72±0.56)分、(3.26±0.61)分、(3.21±0.73)分,均较术前(7.34±1.23)分明显下降。颈椎病症状与功能评分分别为(26.16±3.24)分、(25.21±2.63)分、(26.08±2.53)分、(26.58±3.03)分,均较术前(14.43±2.32)分明显改善。改良Macnab疗效分级评分显示有效率分别为86.67%、80.00%、80.00%、73.33%。结论超声引导结合X线定位下颈椎间盘穿刺髓核射频消融术近期疗效良好,可避免颈部血管食管等损伤且无辐射伤害,是一种安全可行的辅助穿刺方法。【Objective】To discuss the method and recent clinical efficacy of ultrasound guided cervical disc puncture plasma pulloid ablation for treatment of cervical spondylosis.【Methods】From May 2016 to May 2021,15 patients with cervical spondylosis underwent ultrasound-guided radiofrequency ablation of percutaneous cervical disc.Fifteen patients were followed-up for more than half a year,including 6 with radicular type cervical spondylosis,3 with cervical myelopathy,4 with neck type cervical spondylosis,and 2 with mixed cervical spondylosis.Two cases were males and 13 females,aged 36-72 years,with a mean age of 58±2 years.The efficacy and efficiency of 1 week,1 month,3 months and 6 months after surgery were evaluated by Visual Analogue Scale(VAS),scoring table of symptoms and function of cervical vertigo of cervical spondylosis,and modified Macnab efficacy score.【Results】All patients had no immediate intraoperative vascular-oesophageal injury.Of the 15 follow-up patients,there were no hematoma,nerve injury,infection and other complications.One week,1 month,3 months,6 months after treatment,VAS scores were 2.61±0.42,2.72±0.56,3.26±0.61,3.21±0.73,respectively,significantly lower than preoperative 7.34±1.23.The symptoms and functional scores of cervical spondylosis were 26.16±3.24,25.21±2.63,26.08±2.53,26.58±3.03,respectively,significantly lower than preoperative 14.43±2.32.The modified Macnab efficacy grading score showed an efficiency of 86.67%,80.00%,80.00%,73.33%,respectively.【Conclusion】Ultrasound guidance and X-ray positioning,radiofrequency ablation of cervical disc puncture has a good clinical effect recently in the treatment of cervical spondylosis,which can avoid cervical vascular and esophagus damage and no radiation damage,which is a safe and feasible auxiliary puncture method.

关 键 词：颈椎病 超声引导 颈椎间盘 髓核消融术 

分 类 号：R681.53[医药卫生—骨科学]