神经根型颈椎病患者行后路经皮脊柱内镜下手术效果及疗效影响因素分析  

Nerve root type of cervical spondylosis patients through skin after spinal endoscopic surgery effect and factors affecting curative effect analysis

作　　者：李鹏 单乐群 赵鹏飞 LI Peng;SHAN Le-qun;ZHAO Peng-fei(Department of Spine Surgery,Ankang People's Hospital,Ankang Shaanxi 725000,China;Department of Spine Degeneration and Tumor,Xi'an Honghui Hospital,Xi'an Shaanxi 710000,China;Department of Orthopedics,Ankang People's Hospital,Ankang Shaanxi 725000,China)

机构地区：[1]安康市人民医院脊柱外科,陕西安康725000 [2]西安市红会医院脊柱退变与肿瘤病区,陕西西安710000 [3]安康市人民医院骨科,陕西安康725000

出　　处：《临床和实验医学杂志》2024年第23期2522-2526,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目(编号:2023-YBSF-667)。

摘　　要：目的分析神经根型颈椎病患者行后路经皮脊柱内镜下手术效果及疗效影响因素。方法前瞻性选择2022年1月至2023年1月安康市人民医院收治的108例神经根型颈椎病患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各54例。观察组行后路经皮脊柱内镜下手术治疗,对照组行前路颈椎间盘切除融合术治疗。比较两组手术情况、术前1 d及术后6个月、12个月的颈椎功能障碍指数(NDI)、颈部疼痛视觉模拟评分法(VAS)、颈椎生理曲度、病变椎间高度及临床疗效。使用单因素和多因素Logistic回归分析疗效的影响因素。结果观察组的手术时间、首次下床时间、术后住院时间分别为(74.43±14.17)min、(18.08±2.49)h、(3.62±0.83)d,均短于对照组[(88.76±18.52)min、(26.26±5.71)h、(6.41±1.38)d],观察组术中出血量为(14.24±4.83)mL,少于对照组[(76.81±16.08)mL],差异均有统计学意义(P<0.05)。术后6、12个月,两组NDI指数、颈部VAS评分均较术前降低,且观察组术后6个月的NDI指数、颈部VAS评分分别为(12.01±2.13)%、(1.61±0.60)分,均小于对照组[(14.27±2.69)%、(1.92±0.85)分],差异均有统计学意义(P<0.05);两组术后12个月的NDI指数、颈部VAS评分比较,差异均无统计学意义(P>0.05)。术后6、12个月,对照组颈椎生理曲度、病变椎间高度均较术前升高,差异均有统计学意义(P<0.05),观察组颈椎生理曲度、病变椎间高度较术前比较,差异均无统计学意义(P>0.05);观察组术后6、12个月的颈椎生理曲度分别为(9.50±3.14)°、(9.83±3.21)°,病变椎间高度分别为(4.78±0.82)、(4.75±0.88)mm,均小于对照组[(16.46±5.17)°、(14.79±4.52)°和(6.89±1.15)、(6.60±1.15)mm],差异均有统计学意义(P<0.05)。观察组和对照组疗效优良率比较(88.89%vs.85.19%),差异无统计学意义(P>0.05)。根据108例患者的疗效分组,疗效良好组共94例,疗效不佳组共14例。疗效良好组与疗效�Objective To analyze the effect and influencing factors of posterior approach percutaneous spinal endoscopic surgery in patients with radiculopathy.Methods A total of 108 patients with cervical radiculopathy admitted to Ankang People's Hospital from January 2022 to January 2023 were prospectively selected as the study subjects,and they were divided into the observation group and the control group according to the random number table method,with 54 cases in each group.The observation group underwent posterior percutaneous spinal endoscopic surgery,and the control group underwent anterior cervical discectomy and fusion.The surgical conditions,neck disability index(NDI),visual analogue score(VAS)of neck pain,physiological curvature of cervical spine,intervertebral height of lesions at 1 day before operation,6 months and 12 months after operation,and clinical efficacy were compared between the two groups.The influencing factors of efficacy was analyzed using univariate,multivariate Logistic regression analysis.Results The operation time,first time to get out of bed,and postoperative hospital stay in the observation group were(74.43±14.17)min,(18.08±2.49)h,and(3.62±0.83)d,respectively,which were shorter than those in the control group[(88.76±18.52)min,(26.26±5.71)h,(6.41±1.38)d],the intraoperative blood loss was(14.24±4.83)mL,which was less than that in the control group[(76.81±16.08)mL],and the differences were statistically significant(P<0.05).At 6 and 12 months after operation,the NDI index and neck VAS score of the two groups were lower than those before operation,and the NDI index and neck VAS score of the observation group at 6 months after operation were(12.01±2.13)%and(1.61±0.60)points,respectively,which were lower than those of the control group[(14.27±2.69)%,(1.92±0.85)points],the differences were statistically significant(P<0.05).There were no statistically significant differences in NDI index and neck VAS score between the two groups at 12 months after operation(P>0.05).At 6 and 12 months after

关 键 词：神经根型颈椎病 后路 经皮脊柱内镜 疗效 影响因素 

分 类 号：R68[医药卫生—骨科学]