Singrakhia Manoj Dayalal, Malewar Nikhil Ramdas, Deshmukh Sonal, Deshmukh Shivaji
Department of Spine Surgery, Shanta spine Institute, Nagpur, Maharastra, India.
Department of Anaesthesia, Shanta spine Institute, Nagpur, Maharastra, India.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1118-1122. doi: 10.4103/ajns.AJNS_14_17.
Anterior cervical procedures are associated with many intra- and post-operative complications leading to long-term patient morbidity. In this study, we have evaluated the clinical and radiological Outcome of day care posterior cervical foraminotomy in patients with single-level cervical radiculopathy with or without neurodeficit.
Seventeen patients underwent single-level posterior cervical foraminotomy for radicular symptoms were studied between June 2011 and May 2016. Clinical outcome was studied by visual analog scale (VAS) score, neck disability index (NDI), and Odom's criteria. Adjacent segment degeneration was evaluated on lateral cervical radiograph at every follow-up by calculating the focal and global angulation of the cervical spine and disc height at the operated level and adjacent segments. Dynamic lateral cervical spine radiograph was done to evaluate segmental instability.
After a mean follow-up duration of 30.64 months, 13 patients had excellent, three patients had good, and one patient had fair outcome as per Odom's criteria. The mean VAS score for radicular pain, neck pain, and NDI was significantly reduced postoperatively ( < 0.001). The mean focal angulation, mean global angulation, the disc height at operated and adjacent level were not changed significantly ( > 0.05). There was no instability noted postoperatively on lateral dynamic cervical spine radiographs. There was no complication in our study.
Posterior cervical foraminotomy is an effective surgical method for treatment of patients with single-level cervical radiculopathy and helps to achieve good clinical and radiological outcome, prevents postoperative adjacent segment degeneration and instability with minimal complications.
颈椎前路手术与许多术中及术后并发症相关,可导致患者长期发病。在本研究中,我们评估了日间手术颈椎后路椎间孔切开术治疗单节段颈椎神经根病伴或不伴神经功能缺损患者的临床和影像学结果。
对2011年6月至2016年5月期间接受单节段颈椎后路椎间孔切开术治疗神经根症状的17例患者进行研究。通过视觉模拟量表(VAS)评分、颈部功能障碍指数(NDI)和奥多姆标准研究临床结果。每次随访时,通过计算手术节段及相邻节段颈椎的局部和整体成角以及椎间盘高度,在颈椎侧位X线片上评估相邻节段退变情况。进行颈椎动态侧位X线片检查以评估节段稳定性。
根据奥多姆标准,平均随访30.64个月后,13例患者效果极佳,3例患者效果良好,1例患者效果尚可。术后神经根性疼痛、颈部疼痛的平均VAS评分及NDI均显著降低(<0.001)。手术节段及相邻节段的平均局部成角、平均整体成角以及椎间盘高度均无显著变化(>0.05)。颈椎动态侧位X线片检查未发现术后不稳定情况。本研究中无并发症发生。
颈椎后路椎间孔切开术是治疗单节段颈椎神经根病患者的有效手术方法,有助于取得良好的临床和影像学结果,预防术后相邻节段退变和不稳定,且并发症极少。