Bacigaluppi Susanna, Bragazzi Nicola L, Zella Samis, Prada Francesco, Zavanone Mario L, Rampini Paolo
Neurosurgery, Fondazione IRCCS Ca' Granda Maggiore Policlinico Hospital, University of Milan, Milan, Italy -
Department of Neurosurgery, E.O. Ospedali Galliera, Genoa, Italy -
J Neurosurg Sci. 2019 Feb;63(1):30-35. doi: 10.23736/S0390-5616.16.03774-7. Epub 2016 Jul 7.
Does posterior cervical herniectomy impact on symptoms related to cervical paramedian/lateral soft disc herniation?
In a patient series over 15 years operated for single level paramedian/lateral soft disc herniation with posterior cervical approach, perceived radicular and cervical pre- and postoperative symptoms were reconstructed and analyzed.
Out of 105 patients with these characteristics 75 could be recruited for long-term follow-up. Preoperative symptoms included: radicular motor deficit (81.3%); radicular pain (93.3%); radicular sensory deficit (84%); cervical pain (80%) and disturbance of cervical motility (49.3%). Postoperatively radicular motor score improved in all patients (score 5 in 92% and 4 in 8%); sensory disturbance improved in all and radicular pain disappeared in 90% and improved in the others. Cervical pain disappeared in 78% and improved in other 22%, two had new onset moderate cervical pain.
This series confirms safety and efficacy of the posterior approach in relieving motor and sensory symptoms in patients with symptomatic single level, lateral soft disc herniation.
颈椎后路椎间盘切除术对与颈椎旁正中/外侧软性椎间盘突出相关的症状有何影响？
在一组超过15年接受颈椎后路单节段旁正中/外侧软性椎间盘突出手术的患者中，重建并分析了术前和术后神经根性及颈部症状。
在105例具有这些特征的患者中，75例可纳入长期随访。术前症状包括：神经根性运动功能障碍（81.3%）；神经根性疼痛（93.3%）；神经根性感觉功能障碍（84%）；颈部疼痛（80%）和颈部活动障碍（49.3%）。术后所有患者的神经根性运动评分均有改善（92%为5分，8%为4分）；感觉障碍均有改善，90%的患者神经根性疼痛消失，其余患者疼痛减轻。78%的患者颈部疼痛消失，22%的患者疼痛减轻，2例出现新的中度颈部疼痛。
本系列研究证实了后路手术在缓解有症状的单节段外侧软性椎间盘突出患者的运动和感觉症状方面的安全性和有效性。
