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首次使用一种用于颈椎间盘突出症的新型经皮内镜椎间盘切除术技术的经验。

The first experience with a new technique of portal endoscopic discectomy for herniated cervical discs.

作者信息

Gushcha A O, Arestov S O, Vershinin A V

机构信息

Research Center of Neurology, Moscow, Russia.

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2016;80(6):15-23. doi: 10.17116/neiro201680615-23.

Abstract

UNLABELLED

Choosing the most appropriate tactics for surgical treatment of herniated cervical discs is a topical issue to be discussed. The idea of herniated disc removal using an endoscopic technique is not new. This is routine surgery for the lumbar spine. However, application of endoscopic techniques in surgery on the cervical spine was first reported only in 2014 (J. Yang, et al.).

OBJECTIVE

To master the methodology of a new technique, portal endoscopic discectomy, and define the indications for this surgery on herniated cervical discs; to compare outcomes of this surgery with outcomes of anterior microsurgical discectomy.

MATERIAL AND METHODS

The study included 25 patients who underwent portal endoscopic cervical discectomy. A comparison group consisted of 25 patients who underwent anterior microsurgical discectomy and placement of an interbody cage.

RESULTS

A comparison of the results of surgeries revealed no significant difference (p>0.05) in the degree of postoperative local and radicular pain syndrome. According to the Neck Disability Index (NDI), a significant improvement occurred in patients with endoscopic surgery. According to the Odom criterion, a significant advantage in the number of excellent and good outcomes occurred in patients of the study group. There were significant differences between groups in the duration of postoperative hospital stay. The duration was 3 days in the study group and 5 days in the control group, on average.

CONCLUSION

Portal endoscopic discectomy is highly efficient in treatment of herniated cervical discs and enables achieving clinical outcomes associated with much less surgical trauma. The study demonstrates not only the efficacy of the suggested technique but also its safety compared to that of traditional anterior microsurgical techniques that usually involve interbody fusion. This surgery surpasses other interventions in the rate of rehabilitation and social adaptation of patients as well as reduces postoperative hospital stay.

摘要

未标注

选择最合适的手术策略治疗颈椎间盘突出症是一个亟待讨论的热门问题。使用内镜技术切除椎间盘的想法并不新鲜。这是腰椎的常规手术。然而,内镜技术在颈椎手术中的应用直到2014年才首次被报道(J. Yang等人)。

目的

掌握一种新技术——经皮内镜下椎间盘切除术的方法,并确定该手术治疗颈椎间盘突出症的适应症;将该手术的结果与前路显微椎间盘切除术的结果进行比较。

材料与方法

该研究纳入了25例行经皮内镜下颈椎间盘切除术的患者。对照组由25例行前路显微椎间盘切除术并植入椎间融合器(cage)的患者组成。

结果

手术结果比较显示,术后局部和神经根性疼痛综合征的程度无显著差异(p>0.05)。根据颈部功能障碍指数(NDI),内镜手术患者有显著改善。根据奥多姆标准,研究组患者的优良结果数量有显著优势。两组术后住院时间存在显著差异。研究组平均住院时间为3天,对照组为5天。

结论

经皮内镜下椎间盘切除术治疗颈椎间盘突出症效率高,能获得与手术创伤小得多相关的临床结果。该研究不仅证明了所建议技术的有效性,还证明了与通常涉及椎间融合的传统前路显微技术相比其安全性。该手术在患者康复和社会适应率方面超过其他干预措施,还缩短了术后住院时间。

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