Tan Jiangwei, Zheng Yanping, Gong Liangtai, Liu Xinyu, Li Jianmin, Du Wei
Department of Orthopedic Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
J Neurosurg Spine. 2008 Jan;8(1):17-21. doi: 10.3171/SPI-08/01/017.
The authors report the short-term results of anterior cervical discectomy and interbody fusion performed via an endoscopic approach.
Thirty-six patients who underwent anterior cervical discectomy and fusion (ACDF) performed using endoscopic surgery were selected for this study. The indications for surgery were cervical disc herniation caused by neck injury, spondylotic myelopathy, cervical radiculopathy, and solitary ossification of the posterior longitudinal ligament (OPLL). The involved levels included C3-4, C4-5, C5-6, and C6-7. The working channel was inserted through a 20-mm transverse incision, the protruding discs or area of OPLL were excised for complete decompression, and then an appropriate intervertebral polyetheretherketone fusion cage was implanted.
The time spent in surgery was 120 minutes on average (range 50-150 minutes), and the mean blood loss was 55 ml (range 20-140 ml). There were no intraoperative complications and no symptoms of irritation in the laryngopharynx after surgery. However, postoperative hemorrhage of the incision occurred in 1 case. The follow-up period ranged from 26-50 months (mean 38.5 months). Postoperative Japanese Orthopaedic Association and visual analog scale scores improved significantly.
Endoscopic surgery for ACDF can produce satisfactory results in patients with cervical disc herniation, cervical myelopathy, or radiculopathy. The optimal levels for this procedure are C4-5 and C5-6. Compared with a traditional approach, this technique has great advantages in terms of cosmetic results, intraoperative visualization, and postoperative recovery course. Nevertheless, every precaution should be taken to avoid possible complications, such as postoperative hemorrhage.
作者报告经内镜入路行颈椎前路椎间盘切除及椎间融合术的短期结果。
本研究选取36例行内镜下颈椎前路椎间盘切除及融合术（ACDF）的患者。手术适应证为颈部损伤所致颈椎间盘突出症、脊髓型颈椎病、神经根型颈椎病及孤立性后纵韧带骨化（OPLL）。受累节段包括C3 - 4、C4 - 5、C5 - 6和C6 - 7。通过一个20毫米的横向切口插入工作通道，切除突出的椎间盘或OPLL区域以实现完全减压，然后植入合适的椎间聚醚醚酮融合器。
手术平均用时120分钟（范围50 - 150分钟），平均失血量为55毫升（范围20 - 140毫升）。术中无并发症发生，术后咽喉部无刺激症状。然而，有1例发生了切口术后出血。随访期为26 - 50个月（平均38.5个月）。术后日本矫形外科学会评分和视觉模拟量表评分显著改善。
对于颈椎间盘突出症、脊髓型颈椎病或神经根型颈椎病患者，内镜下ACDF手术可产生满意的效果。该手术的最佳节段为C4 - 5和C5 - 6。与传统手术方法相比，该技术在美容效果、术中视野及术后恢复过程方面具有很大优势。尽管如此，应采取一切预防措施以避免可能的并发症，如术后出血。
