颈椎间孔狭窄症内镜循椎弓根减压  

Endoscopic along-pedicular decompression for cervical foraminal stenosis

作　　者：崔志健 李越[1] 楚福明[1] 吴忌[1] 唐小松[1] 王雯[1] 黄子洋 肖清清[1] 邓尚[1] CUI Zhi-jian;LI Yue;CHU Fu-ming;WU Ji;TANG Xiao-song;WANG Wen;HUANG Zi-yang;XIAO Qing-qing;DENG Shang(Sichuan Provincial Orthopaedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《中国矫形外科杂志》2023年第21期2013-2016,共4页Orthopedic Journal of China

基　　金：四川省医学会-医学科研课题项目(编号:S21001)。

摘　　要：[目的]探讨经皮内镜循椎弓根减压术治疗颈椎间孔狭窄症的临床疗效。[方法]回顾性分析2021年6月—2022年6月采用经皮内镜循椎弓根减压术治疗的47例颈椎间孔狭窄症患者的临床资料,评价临床及影像结果。[结果] 47例患者均顺利完成手术,手术时间平均(58.8±21.2) min,术中失血量平均(17.5±8.2) ml,术后切口愈合均良好。随访时间平均(8.2±4.5)个月,与术前相比,术后次日及末次随访时,患者颈肩痛疼痛视觉模拟评分(visual analogue scale,VAS)[(5.1±1.4),(0.8±1.2),(0.4±0.7),P<0.05]、上肢痛VAS评分[(5.1±1.4),(0.5±0.8),(0.2±0.6),P<0.05]、颈椎功能障碍指数(neck disability index,NDI)[(24.9±4.8),(2.4±2.6),(1.2±1.2),P<0.05]均显著减少。影像方面,与术前相比,术后次日及末次随访时,椎间孔内口与椎间孔纵轴垂直距离(internal foraminal diameter,IFD)[(3.5±1.1) mm,(4.6±1.1) mm,(4.3±2.2) mm,P<0.05]、椎间孔中口与椎间孔纵轴垂直距离(middle foraminal diameter,MFD)[(3.4±1.2) mm,(4.5±1.3) mm,(4.4±2.5) mm,P<0.05]显著增加,椎间孔外口与椎间孔纵轴垂直距离(distal foraminal diameter,DFD)及椎间孔高度(foraminal height,FH)无显著变化(P>0.05)。[结论]内镜循椎弓根减压术治疗颈椎间孔狭窄症安全可靠,临床疗效满意,对椎间孔内口、中口减压充分。[Objective]To investigate the clinical outcomes of percutaneous endoscopic along-pedicular decompression for cervical foraminal stenosis.[Methods]A retrospective study was conducted on 47 patients who received percutaneous endoscopic along-pedicular decompression for cervical foraminal stenosis from June 2021 to June 2022.The clinical and imaging results were evaluated.[Results]All the 47 patients were successfully operated on,with the average operation time of(58.8±21.2)min,the average intraoperative blood loss of(17.5±8.2)ml,and the good incision healing.As time went during the follow-up period lasted for(8.2±4.5)months on an average,at the time points preoperatively,next day after operation and the latest follow-up,the visual analogue scale(VAS)of neck and shoulder pain[(5.1±1.4),(0.8±1.2),(0.4±0.7),P<0.05],VAS score for upper limb pain[(5.1±1.4),(0.5±0.8),(0.2±0.6),P<0.05],neck disability index(NDI)[(24.94.8),(2.4±2.6),(1.2±1.2),P<0.05]significantly decreased.In terms of imaging,compared with those before surgery,the longitudinal foraminal diameter(IFD)[(3.5±1.1)mm,(4.6±1.1)mm,(4.3±2.2)mm,P<0.05],the middle foraminal diameter r(MFD)[(3.4±1.2)mm,(4.5±1.3)mm,(4.4±2.5)mm,P<0.05)significantly increased,while the distal foraminal diameter(DFD)and foraminal height(FH)remained unchanged the next day after operation and the latest follow-up(P>0.05).[Conclusion]Endoscopic along-pedicle decompression for cervical foraminal stenosis is safe and reliable,with satisfactory clinical efficacy,and sufficient decompression of the internal and middle foraminal outlets.

关 键 词：颈椎 椎间孔狭窄症 内窥镜 减压术 

分 类 号：R687[医药卫生—骨科学]