颈椎后路脊柱内镜下Key-Hole技术治疗神经根型颈椎病  

Treatment of cervical spondylotic radiculopathy with Key-Hole technique under cervical posterior spinal endoscopy

作　　者：陈太声 刘雄 CHENG Taisheng;LIU Xiong(Department of Spine Surgery,Guangxi Guilin Xing'an Jie Head Bone Injury Hospital,Guilin 541300)

机构地区：[1]广西桂林兴安界首骨伤医院脊柱外科,桂林541300

出　　处：《颈腰痛杂志》2025年第2期280-285,共6页The Journal of Cervicodynia and Lumbodynia

基　　金：广西中管局自筹经费课题(GXZYZ20210048)。

摘　　要：目的探讨运用颈后入脊柱微创内镜下Key-Hole技术治疗神经根型颈椎病(CSR)的治疗疗效。方法随机选取81例诊断CSR且进行手术治疗的患者,其中行颈椎前路椎间盘切除减压植骨融合术(ACDF)患者45例,Key-Hole患者36例,两组患者在病程、性别、年龄、损伤节段方面无差别,评估两组患者术前术后疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI),统计两组患者手术时长、住院天数、住院费用。结果所有患者术程顺利,无脊髓损伤,术前两组患者的VAS评分、JOA评分、NDI功能指数无明显差异,随访1个月后Key-Hole组患者较ACDF组患者的VAS评分、JOA评分、NDI功能指数明显改善,随访1年后两组患者的VAS评分、JOA评分、NDI功能指数无明显差异;两组患者手术时长无明显差异,Key-Hole组患者首次下床时间较ACDF组患者明显提前,Key-Hole组患者的住院天数及住院费用较ACDF组患者明显下降。结论Key-hole较ACDF可明显改善CSR患者的VAS评分、JOA评分、NDI功能指数,且长期效果无明显差异,且Key-Hole组患者较ACDF组患者住院费用明显降低,住院时间明显减少。Objective To explore the therapeutic effect of the Key-Hole technique under the minimally invasive endoscopic treatment of cervical spondylotic radiculopathy(CSR).Methods 81 patients diagnosed with CSR and undergoing surgical treatment were randomly selected.Among them,45 patients underwent anterior cervical discectomy,decompression,bone grafting and fusion(ACDF)and 36 patients with Key-Hole.There was no difference in injury level.The VAS score,JOA score,and NDI of patients in the two groups were evaluated before and after the operation,and the operation time,hospitalization days,and hospitalization expenses of the two groups were counted.Results All patients had a smooth operation without spinal cord injury.There was no significant difference in VAS score,JOA score,and NDI between the two groups before surgery.After 1 month of follow-up,the VAS score and JOA score of the Key-Hole group were compared with those of the ACDF group,NDI was significantly improved.After 1 year of follow-up,there was no significant difference in VAS score,JOA score,and NDI between the two groups;there was no significant difference in the length of operation between the two groups.Significantly earlier,the length of hospitalization and hospitalization expenses of patients in the Key-Hole group were significantly lower than those in the ACDF group.Conclusion Compared with ACDF,Key-hole can significantly improve the VAS score,JOA score,and NDI of CSR patients,and there is no significant difference in long-term effects.Moreover,Key-hole patients can significantly reduce hospitalization costs and length of stay compared with ACDF patients.

关 键 词：神经根型颈椎病 脊柱内镜Key-Hole ACDF 脊柱微创 治疗疗效 治疗费用 

分 类 号：R274[医药卫生—中医骨伤科学]