Rodrigues M A, Hanel R A, Prevedello D M, Antoniuk A, Araújo J C
Department of Neurosurgery, Hospital Nossa Senhora das Graças, Curitiba, Paraná, Brazil.
Surg Neurol. 2001 Jan;55(1):17-22; discussion 22. doi: 10.1016/s0090-3019(00)00349-9.
The ideal approach to the treatment of soft cervical disc herniation remains controversial. Recent reports emphasize several variations of anterior cervical approaches, including the introduction of instrumentation techniques. New issues have been raised and modern neurosurgeons seem to be less familiar with the posterior approach. The objective of this study was to analyze the results obtained by surgical treatment via a posterior approach of soft cervical disc herniation.
Fifty-one patients who underwent laminectomy/flavectomy and disc removal for the treatment of soft cervical disc herniation in the period of 1990 to 1999 were analyzed retrospectively. Relief of pain and motor and sensory improvement were the criteria used to measure the success of the procedure.
Most of the patients presented with acute radiculopathy. Radicular involvement was as follows: 25 cases-C7 root, 19 cases-C6 root, 4 cases-C5 root, and 3 cases-C8 root. Total relief of pain was obtained in 49 of 51 patients (96%). Motor improvement was obtained in 35 of 46 patients (76%) and sensory improvement in 22 of 35 patients (62.8%) in the short term. The mean time of hospitalization was 3 days. There was no mortality and no morbidity.
The advantage of this method, in selected cases, over the classical anterior approach, is that there is no need for grafting, thus avoiding the additional pain and possible complications at the donor and receptor sites, while obtaining similar results.
软性颈椎间盘突出症的理想治疗方法仍存在争议。近期报告强调了几种颈椎前路手术的变体，包括引入器械技术。新的问题已经出现，现代神经外科医生似乎对后路手术不太熟悉。本研究的目的是分析通过后路手术治疗软性颈椎间盘突出症所获得的结果。
回顾性分析了1990年至1999年间因治疗软性颈椎间盘突出症而接受椎板切除术/黄韧带切除术及椎间盘切除术的51例患者。疼痛缓解以及运动和感觉功能改善是衡量手术成功与否的标准。
大多数患者表现为急性神经根病。神经根受累情况如下：C7神经根25例，C6神经根19例，C5神经根4例，C8神经根3例。51例患者中有49例（96%）疼痛完全缓解。短期内，46例患者中有35例（76%）运动功能得到改善，35例患者中有22例（62.8%）感觉功能得到改善。平均住院时间为3天。无死亡病例，也无并发症发生。
在特定病例中，这种方法相对于传统前路手术的优势在于无需植骨，从而避免了供体和受体部位的额外疼痛及可能的并发症，同时获得了相似的效果。
