单边双通道内镜下滑移技术治疗双节段神经根型颈椎病的临床疗效  

Clinical effect of unilateral biportal endoscopy sliding technology in the treatment of two-level cervical spondylotic radiculopathy

作　　者：彭柏华 林振 查丁胜[2] 杨裕豪 张嘉晴[3] 吴昊[2] PENG Bohua;LIN Zhen;ZHA Dingsheng;YANG Yuhao;ZHANG Jiaqing;WU Hao(The First Clinical Medical College,Jinan University,Guangzhou 510632,Guangdong,China;Department of Orthopedics,the First Affiliated Hospital of Jinan University,Guangzhou 510630,Guangdong,China;Department of Biochemistry,Jinan University,Guangzhou 510632,Guangdong,China)

机构地区：[1]暨南大学第一临床医学院,广东广州510632 [2]暨南大学附属第一医院骨科,广东广州510630 [3]暨南大学生物化学教研室,广东广州510632

出　　处：《暨南大学学报（自然科学与医学版）》2023年第6期612-618,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家自然科学基金项目(81871798);广东省自然科学基金项目(2021A1515011254);广州市科技计划项目(202102020796)。

摘　　要：目的:探讨单边双通道内镜(UBE)下滑移技术治疗双节段的神经根型颈椎病(CSR)的临床疗效。方法:回顾性分析2021年4月至2022年11月采用UBE下滑移技术治疗双节段CSR患者7例;通过比较术前和术后上肢、颈部疼痛视觉模拟评分(VAS)、颈部功能障碍指数(NDI),评价该术式的临床疗效及比较手术前后颈椎曲度和手术节段关节活动度(ROM)变化。结果:7例患者平均手术时间(120.0±39.7)min;平均术中出血量(24.3±14.0)mL;平均住院时间(4.3±0.8)d。术前平均VAS由(6.7±0.8)分降至术后末次随访的(1.7±0.5)分,术前平均NDI由(59.7±7.0)%降至术后末次随访的(10.7±1.7)%,(P<0.05)。颈椎曲度、手术节段ROM在术后1个月及末次随访时均与术前相比差异无统计学意义(P>0.05)。按照MacNab标准,本组7例患者末次随访时,优4例、良3例,优良率100%。7例患者均顺利完成手术,术后无脑脊液漏、肌力下降、术口感染、硬膜外血肿等严重并发症。结论:UBE下滑移技术是治疗双节段CSR疗效理想且安全的术式。Objective:To evaluate the clinical efficacy of cervical discectomy by unilateral biportal endoscopy(UBE)for cervical spondylotic radiculopathy.Methods:Data of 7 patients with cervical spondylotic radiculopathy who underwent cervical discectomy via UBE from April 2021 to November 2022 were reviewed.Visual analogue scale(VAS),neck disability index(NDI)were recorded to evaluate the clinical outcome.The excellent and good rate of operation was evaluated by using MacNab criteria.The cervical curvature and the surgical segment ROM were compared pre-and post-operation.Results:The mean operation time was(120.0±39.7)min,the mean intraoperative blood loss was(24.3±14.0)mL,the mean postoperative hospitalization time was(4.3±0.8)days.The mean preoperative VAS decreased from(6.7±0.8)to(1.7±0.5)at the last postoperative follow-up,and the mean preoperative NDI decreased from(59.7±7.0)%to(10.7±1.7)%at the last postoperative follow-up(P<0.05).There was no significant difference in cervical curvature and operative segment ROM at 1 month after surgery and at the last follow-up(P>0.05).There was no significant difference in cervical curvature and surgical segment ROM preoperatively and postoperatively(P>0.05).The excellent and good rate was 100%according to MacNab criteria(excellent in 4 cases,good in 3 cases.All the 7 patients were successfully operated without cerebrospinal fluid leakage,muscle strength loss,operative infection,epidural hematoma and other serious complications.Conclusion:UBE sliding technique is an effective and safe operation for treatment of two-level CSR.

关 键 词：双节段神经根型颈椎病 微创手术 单侧双通道脊柱内镜 椎间盘摘除技术 

分 类 号：R681.5[医药卫生—骨科学]