Nanoori Gangnam Hospital, Spine Surgery, Seoul, Republic of South Korea.
Nanoori Gangnam Hospital, Spine Surgery, Seoul, Republic of South Korea; National University Health System, JurongHealth Campus, Orthopaedic Surgery, Singapore.
World Neurosurg. 2020 Aug;140:e273-e282. doi: 10.1016/j.wneu.2020.05.033. Epub 2020 May 11.
Cervical radiculopathy is a common cervical spine condition. There is a paucity of literature discussing the effect of partial pediculotomy and partial vertebrotomy for posterior endoscopic cervical foraminotomy (PPPV PECF) on cervical radiculopathy. We investigated the radiologic and clinical outcomes of this approach.
This was a retrospective evaluation of 30 cases with cervical radiculopathy who underwent PPPV PECF. Preoperative, postoperative roentgenogram for evaluation of stability, computed tomography (CT) evaluation of foraminal dimensions, and area in sagittal view was performed. Three-dimensional reconstruction area of decompression evaluation was performed. Clinical outcomes of the visual analog scale, Oswestry Disability Index, and Macnab score were evaluated.
There was no complication and recurrence in our PPPV PECF cohort during the study period. At preoperative, 1 week postoperative, and 3 months postoperative and final follow-up, the mean visual analog scale score had significant improvement, with scores of 7.6, 3.0, 2.1, and 1.7, respectively, P < 0.05, and also the mean Oswestry Disability Index, with scores of 73.9, 28.1, 23.3, and 21.5 respectively, P < 0.05. Macnab criteria showed all patients scoring good and excellent. Radiologic results showed PPPV PECF had a significant increase in decompression in the foramen area in all CT-measured parameters, as compared with the mean preoperative values; 1) sagittal area increased 60.1 ± 23.1 mm, 2) CT craniocaudal length increased 4.0 ± 1.54 mm, 3) CT ventrodorsal length increased 4.0 ± 1.97 mm, and 4) 3-dimensional CT scan reconstruction decompression area increased 996 ± 266 mm, P < 0.05.
PPPV PECF is a safe route of decompression of cervical spine with good clinical and radiologic outcome.
颈椎神经根病是一种常见的颈椎疾病。目前文献中对于后路内镜下颈椎侧方减压术（PPPV PECF）中部分椎板切除术和部分椎体切除术对颈椎神经根病的影响讨论较少。我们研究了这种方法的放射学和临床结果。
这是对 30 例颈椎神经根病患者行 PPPV PECF 的回顾性评估。术前、术后行 X 线片评估稳定性，行 CT 评估椎间孔大小和矢状位面积。行三维重建减压面积评估。采用视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和 Macnab 评分评估临床结果。
在研究期间，我们的 PPPV PECF 队列中没有出现并发症和复发。在术前、术后 1 周、术后 3 个月和最终随访时，VAS 评分均有显著改善，分别为 7.6、3.0、2.1 和 1.7，P < 0.05，ODI 评分也有显著改善，分别为 73.9、28.1、23.3 和 21.5，P < 0.05。Macnab 标准显示所有患者均为优或良。放射学结果显示，与术前平均水平相比，PPPV PECF 在所有 CT 测量参数中均使椎间孔减压面积显著增加；1）矢状面积增加 60.1 ± 23.1mm；2）CT 颅尾长度增加 4.0 ± 1.54mm；3）CT 腹背长度增加 4.0 ± 1.97mm；4）3 维 CT 扫描重建减压面积增加 996 ± 266mm，P < 0.05。
PPPV PECF 是一种安全的颈椎减压方法，具有良好的临床和放射学结果。
