后路显微内镜下颈椎椎间孔切开术治疗神经根型颈椎病的疗效

[Efficacy of posterior microendoscopic foraminotomy for cervical radiculopathy].

作者信息

Peng Ming, Qi Chao, Lv Daojing, Cao Xinfeng, Peng Guodong, Ma Xiaocheng

机构信息

Department of Orthopaedics, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao Shandong, 266011, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 May;24(5):513-6.

PMID:20540248

Abstract

OBJECTIVE

To evaluate the clinical results of posterior microendoscopic foraminotomy in the treatment of cervical radiculopathy and cervical intervertebral disc protrusion.

METHODS

From February 2004 to June 2007, 24 cases of cervical radiculopathy received posterior microendoscopic foraminotomy. There were 16 males and 8 females, aging 42-68 years (59 years on average), including 16 cases of cervical radiculopathy and 8 cases of cervical intervertebral disc protrusion. The course of disease was 6-15 months. The affected intervertebral discs were C4, 5 in 8 cases, C5, 6 in 12 cases, and C6, 7 in 4 cases. The radiological examinations showed that 8 protrusions included 6 soft tissue protrusions and 2 rigid tissue protrusions, and that cervical radiculopathy were caused by yellow ligament hypertrophy, Luschka's joint hyperplasia, and abnormal position of facet joint. According to Japanese Orthopedic Association (JOA), the score before operation was (12.60 +/- 1.52) points.

RESULTS

The operation time was 90 to 120 minutes (100 minutes on average), the bleeding during operation was 100 to 150 mL (120 mL on average). Nerve root pain were relieved completely in 19 cases and were relieved partly in 4 cases. One case of calcified nucleus pulposus had neurological traction injury and recovered completely after 3 months. All cases were followed up 24-36 months (28 months on average). The radiological examinations after operation showed the intervertebral disc site was decompressed completely and the height of intervertebral disc and the cervical segmental alignment were normal. At 24 months postoperatively, the JOA score was (16.10 +/- 0.29) points, showing significant difference when compared with that of preoperation (P < 0.01).

CONCLUSION

The posterior microendoscopic foraminotomy can get to the operation site with mini-incision, decrease tissue damage during operation, and avoid narrow intervertebral space, so it has satisfactory clinical results.

摘要

目的

评估后路显微内镜下椎间孔切开术治疗神经根型颈椎病和颈椎间盘突出症的临床效果。

方法

2004年2月至2007年6月，对24例神经根型颈椎病患者行后路显微内镜下椎间孔切开术。其中男性16例，女性8例，年龄42 - 68岁（平均59岁），包括神经根型颈椎病16例，颈椎间盘突出症8例。病程6 - 15个月。病变椎间盘节段：C4、5节段8例，C5、6节段12例，C6、7节段4例。影像学检查显示，8例椎间盘突出中，软组织型6例，硬性组织型2例，神经根型颈椎病由黄韧带肥厚、钩椎关节增生及小关节位置异常所致。根据日本骨科协会（JOA）评分，术前评分为（12.60±1.52）分。

结果

手术时间90 - 120分钟（平均100分钟），术中出血100 - 150毫升（平均120毫升）。19例神经根性疼痛完全缓解，4例部分缓解。1例钙化髓核患者出现神经牵拉损伤，3个月后完全恢复。所有病例随访24 - 36个月（平均28个月）。术后影像学检查显示椎间盘部位减压彻底，椎间盘高度及颈椎节段对线正常。术后24个月时，JOA评分为（16.10±0.29）分，与术前相比差异有统计学意义（P < 0.01）。