神经根型颈椎病后路大通道内镜椎板开窗减压  

Posterior large-channel endoscopic laminectomy and decompression for cervical spondylotic radiculopathy

作　　者：陈小鑫 李星晨[1] 徐远志 徐玉生[1] 苗金红[1] 刘鋆宣 杨东林 CHEN Xiao-xin;LI Xing-chen;XU Yuan-zhi;XU Yu-sheng;MIAO Jin-hong;LIU Yun-xuan;YANG Dong-lin(The First Affiliated Hospital,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450000

出　　处：《中国矫形外科杂志》2024年第21期1998-2001,共4页Orthopedic Journal of China

基　　金：河南省医学科技攻关计划省部共建项目(编号:SBGJ2018039);河南省高等学校重点科研项目(编号:20A320083)。

摘　　要：[目的]探讨后路经皮大通道内镜椎板开窗减压治疗神经根型颈椎病的临床疗效。[方法]回顾性分析2021年1月—2022年12月,采用后路经皮大通道内镜椎板开窗减压治疗神经根型颈椎病32例患者的资料,评价临床和影像结果。[结果]32例患者均顺利完成手术,无严重并发症。手术时间平均(39.3±5.8)min,术中出血量平均(15.6±5.4)ml,随访时间平均(16.4±3.5)个月。与术前相比,术后3 d及末次随访时,颈肩痛VAS评分[(6.7±1.0),(2.2±0.5),(1.3±0.4),P<0.001]、上肢痛VAS评分[(7.4±0.8),(2.3±0.9),(1.3±0.5),P<0.001]和NDI评分[(39.6±2.4),(17.7±1.8),(10.7±1.7),P<0.001]均显著降低,JOA评分[(7.3±1.7),(16.4±2.6),(22.63±2.3),P<0.001]显著增加。影像方面,与术前相比,术后3 d及末次随访时,责任节段椎管面积[(1.6±0.1)mm^(2),(1.9±0.1)mm^(2),(2.0±0.1)mm^(2),P<0.001]显著增加,椎间隙高度和颈椎前凸角略有增加,但差异无统计学意义(P>0.05)。[结论]后路经皮大通道内镜椎板开窗减压治疗神经根型颈椎病是一种安全、有效的手术方法。[Objective]To investigate the clinical effect of posterior percutaneous large channel endoscopic laminectomy and decompression in the treatment of cervical spondylotic radiculopathy.[Methods]A retrospective study was conducted on 32 patients who recerved abovementioned surgical procedure for cervical spondylotic radiculopathy from January 2021 to December 2022.The clinical and imaging data were evaluated.[Results]All the 32 patients had operation performed successfully without serious complications,with the average operation time of(39.3±5.8)min,average intraoperative blood loss of(15.6±5.4)ml,and followed up for(16.4±3.5)months in a mean.As time elapsed from the point preoperatively,3 days after surgery to the last follow-up,the neck and shoulder pain VAS score[(6.7±1.0),(2.2±0.5),(1.3±0.4),P<0.001],upper limb pain VAS score[(7.4±0.8),(2.3±0.9),(1.3±0.5),P<0.001]and NDI score[(39.±2.4),(17.7±1.8),(10.7±1.7),P<0.001]significantly declined,whereas JOA score[(7.3±1.7),(16.4±2.6),(22.63±2.3),P<0.001]increased significantly.In terms of imaging,the responsible segment vertebral canal area[(1.6±0.1)mm^(2),(1.9±0.1)mm^(2),(2.0±0.1)mm^(2),P<0.001]was significantly increased 3 days postoperatively and at the last follow-up compared with that preoperatively,while the intervertebral space height and cervical lordosis angle slightly increased,but without statistically significant differences(P>0.05).[Conclusion]Posterior percutaneous large-channel endoscopic laminectomy is a safe and effective surgical method for the treatment of cervical spondylotic radiculopathy.

关 键 词：神经根型颈椎病 大通道内镜 微创手术 颈椎前路减压融合术 

分 类 号：R681.55[医药卫生—骨科学]