脊柱内镜辅助颈前路减压植骨融合术治疗颈椎病的临床疗效研究  

Clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis

作　　者：龚双全 崔立强[1] 谢世明[1] 叶宇 刘泓君 王成龙 刘登上 GONG Shuangquan;CUI Liqiang;XIE Shiming;YE Yu;LIU Hongjun;WANG Chenglong;LIU Dengshang(Department of Minimally Invasive Spine,Mianyang Orthopedic Hospital,Mianyang,Sichuan 621000,P.R.China)

机构地区：[1]绵阳市骨科医院微创脊柱科,四川绵阳621000

出　　处：《华西医学》2024年第10期1526-1530,共5页West China Medical Journal

基　　金：四川省绵阳市卫生健康委基金项目(202244)。

摘　　要：目的研究脊柱内镜辅助颈前路减压植骨融合术治疗颈椎病的临床疗效。方法回顾性收集2021年9月-2023年9月于绵阳市骨科医院采用脊柱内镜(水介质)辅助颈前路减压植骨融合术治疗的颈椎病患者的临床资料。通过术前和末次随访时的患者颈椎功能障碍指数(Neck Disabilitv Index,NDI)、颈椎日本骨科协会(Japanese Orthopaedic Association,JOA)评分及JOA评分改善率、颈椎Cobb角和病变椎间隙高度变化、手术并发症的发生情况评估手术效果及神经损伤恢复情况。结果共纳入患者29例,其中男18例,女11例。平均年龄(52.34±8.96)岁,平均病程(17.31±6.60)个月,平均随访时间(11.69±3.41)个月。末次随访时患者的NDI[(3.55±3.09)vs.(17.28±5.51)分]、Cobb角[(15.25±4.83)vs.(-1.34±7.50)°]、椎间隙高度[(8.04±0.82)vs.(4.67±0.95)mm]、JOA评分[(15.90±1.11)vs.(11.17±1.65)分]均较术前改善(P<0.05)。JOA评分改善率评估显示,优16例,良11例,中2例,优良率93.10%。所有患者术后均未出现严重并发症。结论脊柱内镜(水介质)辅助颈前路减压植骨融合术治疗颈椎病有较好的临床疗效和安全性。Objective To investigate the clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis.Methods The clinical data of patients treated with water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis at Mianyang Orthopedic Hospital between September 2021 and September 2023 were retrospectively collected.The surgical efficacy and nerve injury recovery were evaluated based on the Neck Disabilitv Index(NDI),Japanese Orthopaedic Association(JOA)score,improvement rate of JOA score,Cobb angle and height changes of the affected intervertebral space before surgery and at the last follow-up,as well as the occurrence of surgical complications.Results A total of 29 patients were included,including 18 males and 11 females.The average age was(52.34±8.96)years,and the average duration of illness was(17.31±6.60)months.The average follow-up time was(11.69±3.41)months.At the last follow-up,the patients’NDI(3.55±3.09 vs.17.28±5.51),Cobb angle[(15.25±4.83)vs.(−1.34±7.50)°],intervertebral height[(8.04±0.82)vs.(4.67±0.95)mm],and JOA score(15.90±1.11 vs.11.17±1.65)improved compared to preoperative levels(P<0.05).The JOA score improvement rate assessment showed that 16 cases were excellent,11 cases were fine,2 cases were moderate,and the excellent and fine rate was 93.10%.All patients did not experience serious complications after surgery.Conclusion Water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis has good clinical efficacy and safety.

关 键 词：脊柱内镜 颈椎病 颈前路减压植骨融合术 

分 类 号：R687.3[医药卫生—骨科学]