Orthopedic Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Orthopedic Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
World Neurosurg. 2020 Jan;133:e205-e210. doi: 10.1016/j.wneu.2019.08.210. Epub 2019 Sep 5.
Good short- and mid-term clinical efficacy of percutaneous cervical nucleoplasty (PCN) for cervical degenerative diseases (CDD) with neck pain has been reported. However, few studies have assessed its long-term influence in patients with both neck pain and cervical vertigo. This study aimed to evaluate the curative efficacy of PCN for CDD with neck pain and cervical vertigo with minimum of 6 years of follow-up.
Inpatients who underwent PCN for CDD with neck pain and cervical vertigo between April 2010 and March 2013 were enrolled. Clinical outcomes were assessed using the Cervical Vertigo Evaluation Scale (CVES); greater CVES scores reflected less impairment. Additional open surgeries were recorded.
Among 40 patients, 100% completed the 1-year short-term and 3-year mid-term follow-up (FU); 85% completed the 6-year long-term FU. Clinical effective rates were 67.5%, 67.5%, and 52.94% at short-, mid-, and long-term FU, respectively. CVES scores were greater than the preoperative CVES scores at all FU timepoints (P < 0.01). However, the CVES score was lower at the final FU than at the 3-year FU (P < 0.05). The neck pain score significantly decreased over time and was lower than the cervical vertigo score at the final FU (P > 0.05). Reoperation rates were 1/40 (2.50%) and 3/34 (8.82%) at mid- and long-term FU, respectively.
PCN in patients with CDD neck pain and cervical vertigo showed satisfactory clinical efficacy at short- and mid-term FU, and it was fair at long-term FU. Thus, PCN could be a complementary operation for CDD.
经皮颈椎间盘髓核成形术（PCN）治疗颈痛型颈椎退行性疾病（CDD）具有良好的短期和中期临床疗效。然而，很少有研究评估其对同时伴有颈痛和颈性眩晕的患者的长期影响。本研究旨在评估 PCN 治疗颈痛型 CDD 伴颈性眩晕的疗效，随访时间至少为 6 年。
2010 年 4 月至 2013 年 3 月，收治因颈痛型 CDD 伴颈性眩晕而行 PCN 治疗的住院患者。采用颈性眩晕评估量表（CVES）评估临床疗效；CVES 评分越高，表明损害越轻。记录了额外的开放手术。
40 例患者中，100%完成了 1 年短期和 3 年中期随访（FU），85%完成了 6 年长期 FU。短期、中期和长期 FU 的临床有效率分别为 67.5%、67.5%和 52.94%。CVES 评分在所有 FU 时间点均高于术前 CVES 评分（P < 0.01）。然而，最终 FU 的 CVES 评分低于 3 年 FU（P < 0.05）。颈部疼痛评分随时间逐渐下降，最终 FU 时低于颈性眩晕评分（P > 0.05）。中期和长期 FU 的再手术率分别为 1/40（2.50%）和 3/34（8.82%）。
PCN 治疗颈痛型 CDD 伴颈性眩晕在短期和中期 FU 时显示出良好的临床疗效，在长期 FU 时效果尚可。因此，PCN 可作为 CDD 的一种补充治疗手段。
