Neurosurgery,Yangzhou Hongquan Hospital, Yangzhou 225200, Jiangsu, China.
J Healthc Eng. 2021 Dec 17;2021:7245566. doi: 10.1155/2021/7245566. eCollection 2021.
In the past 10 years, the technology of percutaneous spine endoscopy has been continuously developed. The indications have expanded from simple lumbar disc herniation to various degenerative diseases of the cervical, thoracic, and lumbar spine. Traditional surgery for the treatment of cervical radiculopathy includes anterior cervical decompression surgery, anterior cervical decompression plus fusion surgery, and posterior limited fenestration surgery. This article mainly studies the treatment of cervical spondylosis caused by radiculopathy caused by the nucleus resection of the posterior cervical spine percutaneous spinal endoscopy based on deep learning. In the PPECD group, the height of the intervertebral cavity was measured before the operation and during the final follow-up, and the height change of the intervertebral cavity was evaluated. The relative angle and relative displacement of the sagittal plane of the operation segment in the PPECD group were measured, and the stability was evaluated. Using the cervical spine X-ray Kelvin degeneration evaluation criteria, before and during the final follow-up operation, the degeneration of the adjacent segments of the two groups was evaluated. A retrospective analysis of 26 cases of cervical radiculopathy that met the criteria for diagnosis, inclusion, and exclusion was reviewed. Among them, 11 cases were treated with PPECD surgery; 15 cases were treated with ACDF surgery. According to the evaluation method of Odom, the excellent rate and the good rate of the two groups were compared. According to the location of the lesion, the nerve detection or dull tip device is exposed under the armpit or shoulder of the nerve root, and the protruding nucleus pulposus tissue is explored and removed, and annulus fibrosus is performed as needed. After hemostasis was detected, the surgical instruments were removed and the surgical incision was completely sutured. Before the operation and 3 months after the operation, the final follow-up made no significant difference in the overall average height of the intervertebral cavity ( = 2.586, > 0.05). The results show that posterior foramen expansion is an effective surgical method for the treatment of cervical spondylotic radiculopathy, but surgical adaptation requires strict management. In order to achieve satisfactory results, appropriate cases must be selected.
在过去的 10 年中，经皮脊柱内窥镜技术不断发展。其适应证已从单纯腰椎间盘突出症扩展到颈椎、胸椎和腰椎的各种退行性疾病。传统的颈椎神经根病治疗方法包括前路颈椎减压手术、前路颈椎减压加融合手术和后路有限开窗手术。本文主要研究基于深度学习的后路颈椎经皮脊柱内窥镜下颈椎间盘核切除术治疗神经根型颈椎病。在 PPECD 组中，在术前和末次随访时测量椎间腔高度，并评估椎间腔高度变化。测量 PPECD 组手术节段矢状面的相对角度和相对位移，并评估稳定性。使用颈椎 X 射线 Kelvin 退变评价标准，在术前和末次随访时评价两组相邻节段的退变情况。回顾性分析符合诊断、纳入和排除标准的 26 例颈椎神经根病患者。其中，11 例采用 PPECD 手术治疗；15 例行 ACDF 手术。根据 Odom 评价方法比较两组的优良率。根据病变部位，在腋窝或肩部神经根下暴露神经探测或钝端器械，探查并切除突出的椎间盘组织，必要时切除纤维环。止血后取出手术器械，完全缝合手术切口。术前和术后 3 个月，终末随访时椎间腔总平均高度无显著差异（ = 2.586， > 0.05）。结果表明，后路椎间孔扩大是治疗神经根型颈椎病的有效手术方法，但手术适应需要严格管理。为了取得满意的效果，必须选择合适的病例。
