3D显微镜辅助下经前路治疗合并骨性颈椎间孔狭窄的神经根型颈椎病的疗效观察  

Therapeutic Effectiveness of 3⁃Dimensional Exoscope System⁃Assisted Anterior Approach Treatment for Cervical Spondylotic Radiculopathy with Osseous Foraminal Stenosis

作　　者：糜宝国 张吉涛 姜扩 孟海兰 王博文 郝定均[1] 单乐群 MI Baoguo;ZHANG Jitao;JIANG Kuo;MENG Hailan;WANG Bowen;HAO Dingjun;SHAN Lequn(Department of Spine Surgery,Honghui Hospital,Medical College of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学医学院附属红会医院脊柱外科,西安710054

出　　处：《骨科》2024年第1期1-5,共5页ORTHOPAEDICS

基　　金：陕西省重点研发计划(2023YBSF667)。

摘　　要：目的探讨3D显微镜辅助下经颈椎前路减压融合术(anterior cervical discectomy and fusion,ACDF)治疗合并骨性颈椎间孔狭窄的神经根型颈椎病的疗效及安全性。方法回顾性分析我院2019年1月至2020年12月的36例接受3D显微镜辅助下ACDF手术治疗合并骨性颈椎间孔狭窄的神经根型颈椎病病人的临床资料。观察病人术中出血量、术后引流量以及手术并发症发生情况。比较病人术前及末次随访时的颈痛、上肢痛视觉模拟量表(VAS)评分和颈椎功能障碍指数(NDI)。结果所有病人均成功实施手术,未发生血管、神经损伤等严重并发症。术中出血量为(56.4±22.3)mL,术后引流量为(6.7±4.6)mL。末次随访时颈痛VAS评分、上肢痛VAS评分及NDI指数别为(1.1±0.8)分、(1.4±0.9)分和15.6%±4.6%,较术前的(4.8±1.1)分、(6.3±0.9)分和49.3%±6.7%明显降低,差异有统计学意义(P<0.05)。结论3D显微镜辅助下经前路治疗合并骨性颈椎间孔狭窄的神经根型颈椎病疗效确切,是一种高效、安全、可视化的手术技术,值得临床上推广应用。Objective To explore the efficacy and safety of anterior cervical decompression and fusion(ACDF)assisted by 3⁃Dimensional(3D)exoscope system for the treatment of cervical spondylotic radiculopathy with osseous foraminal stenosis.Methods A retrospective analysis was conducted on the clinical data of 36 patients with cervical spondylotic radiculopathy with osseous foraminal stenosis who underwent ACDF surgery assisted by 3D exoscope system from January 2019 to December 2020 in our hospital.The intraoperative bleeding volume,postoperative drainage volume,and the surgical complications were observed.The visual analogue scale(VAS)of neck pain,upper limb pain and neck disability index(NDI)were compared.Results All patients underwent surgery successfully and did not experience serious complications such as vascular and nerve damage.The intraoperative bleeding volume was(56.4±22.3)mL,and the postoperative drainage volume was(6.7±4.6)mL.At the last follow⁃up,the neck pain VAS score,upper limb pain VAS score,and NDI were 1.1±0.8,1.4±0.9,and 15.6%±4.6%,respectively,which were significantly lower than the preoperative 4.8±1.1,6.3±0.9,and 49.3%±6.7%(P<0.05).Conclusion The effectiveness of 3D exoscope system assisted⁃anterior approach treatment for cervical spondylotic radiculopathy with osseous foraminal stenosis is accurate,with unique advantages.It is an efficient,safe,and visual surgical technique that is worthy of clinical promotion and application.

关 键 词：3D显微镜 神经根型颈椎病 骨性椎间孔狭窄 减压 前路 

分 类 号：R687.3[医药卫生—骨科学]