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内镜下颈椎后路椎间孔切开术治疗骨性椎间孔狭窄

Endoscopic Posterior Cervical Foraminotomy as a Treatment for Osseous Foraminal Stenosis.

作者信息

Oertel Joachim M K, Philipps Mark, Burkhardt Benedikt W

机构信息

Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.

Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.

出版信息

World Neurosurg. 2016 Jul;91:50-7. doi: 10.1016/j.wneu.2016.02.073. Epub 2016 Mar 15.

Abstract

BACKGROUND

Posterior cervical foraminotomy is a valuable treatment option for cervical radiculopathy. Here the authors present their technique and results in the treatment of a series of patients suffering from osseous foraminal stenosis.

METHODS

Forty-three patients suffering from cervical osseous foraminal stenosis were operated on via a posterior approach with the EasyGO endoscopic system. Decompression was performed in 1 segment in 31 patients, in 2 segments in 11 patients, and in 3 segments in 1 patient. Bilateral decompression was performed in 4 cases. Twenty-four (55.8%) patients had been subjected to previous spine surgery. All procedures were video recorded and afterwards retrospectively analyzed. In addition, particular reference was given to previous cervical spine surgery, postoperative outcome, reoperation rate, and complications.

RESULTS

The endoscopic system was easy to handle intraoperatively in all procedures. No emergency stopping was required. Forty-one patients reported improved and/or even no remaining pain postoperatively (95%). Thirty-five patients (81.4%) regained full motor strength. Clinical success rate with respect to Odom's criteria reached 39 patients (90.7%). One reoperation was needed due to postoperative hematoma (2.3%). One patient suffered from transient worsening of his preoperative paresis (2.3%). Neither dural tear nor nerve root injury was observed. Reoperation rate due to degenerative changes was 18.6% (8 of 43 patients).

CONCLUSIONS

This retrospective analysis shows that posterior endoscopic decompression is a successful option in the treatment of osseous cervical foraminal stenosis.

摘要

背景

颈椎后路椎间孔切开术是治疗神经根型颈椎病的一种有效治疗选择。在此,作者介绍了他们治疗一系列患有骨性椎间孔狭窄患者的技术及结果。

方法

43例患有颈椎骨性椎间孔狭窄的患者通过EasyGO内镜系统经后路进行手术。31例患者在1个节段进行减压,11例患者在2个节段进行减压,1例患者在3个节段进行减压。4例患者进行了双侧减压。24例(55.8%)患者曾接受过脊柱手术。所有手术均进行了视频记录,随后进行回顾性分析。此外,特别提及了既往颈椎手术情况、术后结果、再次手术率及并发症。

结果

在所有手术中,内镜系统在术中易于操作。无需紧急停止手术。41例患者术后报告疼痛改善和/或甚至无残留疼痛(95%)。35例患者(81.4%)恢复了全部运动力量。根据奥多姆标准,临床成功率达到39例患者(90.7%)。因术后血肿需要进行1次再次手术(2.3%)。1例患者术前麻痹出现短暂加重(2.3%)。未观察到硬脊膜撕裂或神经根损伤。因退变改变导致的再次手术率为18.6%(43例患者中的8例)。

结论

这项回顾性分析表明,后路内镜减压是治疗颈椎骨性椎间孔狭窄的一种成功选择。

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