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经皮等离子激光椎间盘消融联合导航下减压术治疗颈椎间盘突出症:单中心经验。

Percutaneous plasma laser disc coagulation and navigable ablation decompression in the treatment of cervical disc herniation: a single center experience.

出版信息

Turk J Med Sci. 2019 Feb 11;49(1):258-264. doi: 10.3906/sag-1805-191.

DOI:10.3906/sag-1805-191
PMID:30761876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7350859/
Abstract

BACKGROUND/AIM: We aimed to compare the effectivity of percutaneous disc coagulation therapy (PDCT) and navigable ablation decompression treatment (L-DISQ) in patients who were diagnosed with cervical disc herniation.

MATERIALS AND METHODS

Visual analog scale (VAS) and Neck Pain Index (NPI) scores were recorded initially and at the 1st, 3rd, 6th, and 12th months after the procedures. Patient Satisfaction Scale (PSS) scores were recorded 12 months after the procedures

RESULTS

Mean VAS scores were 7.55 and 3.1 points in the PDCT group and 7.6 and 3.00 points in the L-DISQ group; mean NPI scores were 34.2 and 20.75 points in the PDCT group and and 34.1 and 20.4 points in the L-DISQ group initially and at the 12th month. When compared between months, there was a significant decrease in time-dependent VAS and NPI scores in both PDCT and L-DISQ groups (P = 0.001). Some complications included esophageal, vascular, and neural injuries; hoarseness; Horner syndrome; infections; dural puncture; and muscle spasm. The only difference between groups was the rate of cervical spasm within 1 month after the procedure: 75% in the PDCT group and 15% in the L-DISQ group.

CONCLUSION

The diameter of the canal of the cervical vertebrae is narrower than of the lumbar and thoracic regions; therefore, the smaller part of the disc may be sufficient to create clinical signs. The response to decompression therapies is faster in the case of cervical percutaneous procedures that are performed correctly. Proper patient selection and practitioner’s experience are important in the treatment success

摘要

背景/目的:我们旨在比较经皮椎间盘凝固治疗(PDCT)和导航消融减压治疗(L-DISQ)在诊断为颈椎间盘突出症的患者中的疗效。

材料和方法

最初和治疗后第 1、3、6 和 12 个月记录视觉模拟量表(VAS)和颈部疼痛指数(NPI)评分。治疗后 12 个月记录患者满意度量表(PSS)评分。

结果

PDCT 组的平均 VAS 评分分别为 7.55 和 3.1 分,L-DISQ 组为 7.6 和 3.00 分;PDCT 组的平均 NPI 评分分别为 34.2 和 20.75 分,L-DISQ 组为 34.1 和 20.4 分;治疗后第 12 个月。与各月相比,PDCT 和 L-DISQ 组的 VAS 和 NPI 评分均呈时间依赖性下降(P = 0.001)。一些并发症包括食管、血管和神经损伤;声音嘶哑;霍纳综合征;感染;硬脑膜穿刺;和肌肉痉挛。两组之间唯一的区别是术后 1 个月内颈椎痉挛的发生率:PDCT 组为 75%,L-DISQ 组为 15%。

结论

颈椎椎骨的管腔直径比胸腰椎小;因此,椎间盘的较小部分可能足以产生临床体征。如果正确进行颈椎经皮手术,对减压治疗的反应更快。正确的患者选择和医生的经验在治疗成功中很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87f7/7350859/38541eca03fa/turkjmedsci-49-258-fig001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87f7/7350859/38541eca03fa/turkjmedsci-49-258-fig001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87f7/7350859/38541eca03fa/turkjmedsci-49-258-fig001.jpg

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