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经颈前路椎间盘切除融合术联合钩椎关节切除术治疗神经根型颈椎病时直接神经根减压的安全性和有效性。

Safety and efficacy of direct nerve root decompression via anterior cervical discectomy and fusion with uncinectomy for cervical radiculopathy.

作者信息

Safaee Michael M, Nichols Noah M, Yerneni Ketan, Zhang Yalan, Riew K Daniel, Tan Lee A

机构信息

Department of Neurological Surgery, University of California, San Francisco, CA, USA.

Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

J Spine Surg. 2020 Mar;6(1):205-209. doi: 10.21037/jss.2019.12.04.

Abstract

Cervical radiculopathy is a common spinal condition associated with pain, sensory disturbances, and motor weakness. Symptoms often can be attributable to either disc herniation and/or bony foraminal stenosis due to uncinate hypertrophy. Posterior cervical foraminotomy and conventional anterior cervical discectomy and fusion (ACDF) represent the mainstay of treatment. In patients with severe bony foraminal stenosis, posterior foraminotomy and standard ACDF without complete resection of uncinate process may result in incomplete decompression. ACDF with uncinectomy allows for complete and direct decompression of the exiting nerve root, and may lead to improved clinical outcome in appropriately selected patients. We describe the technique for ACDF with uncinectomy and report the clinical outcome in a consecutive series of patients.

摘要

神经根型颈椎病是一种常见的脊柱疾病,伴有疼痛、感觉障碍和运动无力。症状通常可归因于椎间盘突出和/或由于钩椎关节肥大导致的骨性椎间孔狭窄。后路颈椎椎间孔切开术和传统的前路颈椎间盘切除融合术(ACDF)是主要的治疗方法。在严重骨性椎间孔狭窄的患者中,后路椎间孔切开术和未完全切除钩椎关节的标准ACDF可能导致减压不完全。带钩椎关节切除术的ACDF可对穿出神经根进行完全直接减压,并可能使适当选择的患者临床结果得到改善。我们描述了带钩椎关节切除术的ACDF技术,并报告了一系列连续患者的临床结果。

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