Goel Atul, Dharurkar Pralhad, Shah Abhidha, Gore Sandeep, Bakale Nilesh, Vaja Tejas
Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Mumbai, India; Department of Neurosurgery, Lilavati Hospital and Research Centre, Mumbai, India.
Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Mumbai, India.
World Neurosurg. 2019 Jan;121:e875-e881. doi: 10.1016/j.wneu.2018.10.003. Epub 2018 Oct 11.
We assessed the efficacy of "only fixation" as treatment for cervical radiculopathy.
From 2012 to December 2017, 21 patients who had presented with primary symptoms related to cervical radiculopathy, including radiating pain, tingling paresthesia, numbness, weakness, and wasting were treated by facetal stabilization surgery aimed at achieving segmental arthrodesis. No decompression by removal of bone, disc material, or osteophyte was performed. The age of the patients ranged from 27 to 59 years. Of the 21 patients, 19 were men and 2 were women. The imaging findings showed a herniated disc in 4, a disc bulge in 12, and osteophyte-related foraminal stenosis in 5 patients. Transarticular screw fixation was deployed for surgery. The levels of cervical fixation were guided by the clinical and radiological information and determined by direct observation of the facet morphology and stability by manual manipulation of the bones in the region.
All the patients experienced "remarkable" relief of the presenting radicular symptoms in the "immediate" postoperative period. The visual analog scale and neck disability index scores were used to assess the patients before and after surgical treatment. During the follow-up period, which ranged from 6 to 64 months, all the patients continued to experience satisfactory symptomatic relief.
Instability of the spinal segment is the nodal point of pathogenesis and the primary cause of symptoms related to degenerative spondylotic radiculopathy. The treatment is spinal stabilization. No direct bone or soft tissue decompression is necessary.
我们评估了“单纯固定”作为治疗神经根型颈椎病的疗效。
2012年至2017年12月，21例出现与神经根型颈椎病相关的主要症状（包括放射性疼痛、刺痛、麻木、无力和肌肉萎缩）的患者接受了旨在实现节段性融合的小关节稳定手术。未进行去除骨、椎间盘组织或骨赘的减压操作。患者年龄在27至59岁之间。21例患者中，19例为男性，2例为女性。影像学检查结果显示，4例有椎间盘突出，12例有椎间盘膨出，5例有骨赘相关的椎间孔狭窄。手术采用经关节螺钉固定。颈椎固定水平根据临床和放射学信息确定，并通过手动操作该区域骨骼直接观察小关节形态和稳定性来确定。
所有患者在术后“即刻”均经历了所呈现的神经根症状的“显著”缓解。采用视觉模拟量表和颈部功能障碍指数评分对患者手术前后进行评估。在6至64个月的随访期内，所有患者的症状持续得到满意缓解。
脊柱节段不稳定是发病机制的关键点，也是退行性脊柱病神经根病相关症状的主要原因。治疗方法是脊柱稳定。无需直接进行骨或软组织减压。
