Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.
J Orthop Surg Res. 2022 Aug 13;17(1):389. doi: 10.1186/s13018-022-03274-3.
Posterior minimally invasive surgery has been increasingly used in in recent years for the clinical treatment of cervical spondylosis. However, this treatment remains challenging and has not been comprehensively reported. The aim of this study was to provide a systematic review of posterior minimally invasive treatment for cervical spondylosis to demonstrate the clinical efficacy and safety of this procedure.
We collected information from patients with myelopathy or radiculopathy cervical spondylosis who underwent posterior minimally invasive surgery and verified the clinical efficacy and safety of these surgeries with different measurement indicators from five electronic databases: the Nurick, visual analog scale score, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), EuroQol Five Dimensions Questionnaire (EQ-5D) score, Short-Form Health Survey Physical Component Summary (SF12-PCS) questionnaire score, Short-Form Health Survey Mental Component Summary (SF12-MCS) questionnaire score, and the MOS item short form health survey (HF-36) score. The decompression effect, cervical spine stability, average surgery time, surgical blood loss volume, length of hospital stay, and related complications were included in the descriptive analysis. Reporting of this protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines checklist.
We identified 14 observational studies of cervical spondylosis with 479 patients, mainly including 197 cases of myelopathy and 207 cases of radiculopathy. Channel and endoscopic techniques were used. This study was certified by PROSPERO: CRD42021290074. Significant improvements in the quantitative indicators (Neck-VAS in 9 studies, JOA in 7 studies, NDIs in 5 studies, Nurick, ARM-VAS, and EQ-5D in 2 studies each, and the SF12-PCS, SF12-MCS, and HF-36 in 1 study each) were observed between pre- and postoperation (P < 0.05), and satisfactory clinical significance was acquired in the descriptive indicators [average surgery time (94.56 ± 37.26 min), blood loss volume (68.78 ± 103.31 ml), average length of stay (2.39 ± 1.20 d), and cervical spine stability after surgery]. Additionally, we showed that there was a 4.9% postoperative complication rate and the types of complications that may occur.
Posterior minimally invasive surgery is an effective and safe method for the treatment of cervical spondylosis and is a recommended optional surgical procedure for single-segment myelopathy and radiculopathy.
近年来，后入路微创技术越来越多地应用于颈椎病的临床治疗。然而，这种治疗方法仍具有挑战性，尚未得到全面报道。本研究旨在对后入路微创治疗颈椎病进行系统评价，以展示该手术的临床疗效和安全性。
我们从接受后路微创治疗的脊髓型颈椎病或神经根型颈椎病患者中收集信息，并通过五个电子数据库中的不同测量指标验证这些手术的临床疗效和安全性：Nurick 评分、视觉模拟评分、日本骨科协会（JOA）评分、颈部残疾指数（NDI）、欧洲五维健康量表（EQ-5D）评分、健康调查简表-物理成分评分（SF12-PCS）问卷评分、健康调查简表-精神成分评分（SF12-MCS）问卷评分和 MOS 项目短表健康调查（HF-36）评分。描述性分析包括减压效果、颈椎稳定性、平均手术时间、手术失血量、住院时间和相关并发症。本研究报告遵循系统评价和荟萃分析报告规范（PRISMA）检查表。
我们共纳入了 14 项关于颈椎病的观察性研究，共 479 例患者，主要包括脊髓型颈椎病 197 例，神经根型颈椎病 207 例。采用通道和内镜技术。本研究已通过 PROSPERO 认证：CRD42021290074。术前和术后的定量指标（9 项研究中的颈痛视觉模拟评分、7 项研究中的 JOA 评分、5 项研究中的 NDI、2 项研究中的 Nurick、上肢痛视觉模拟评分和 EQ-5D 评分，以及 1 项研究中的 SF12-PCS、SF12-MCS 和 HF-36 评分）均有显著改善（P<0.05），在描述性指标方面也获得了满意的临床意义[平均手术时间（94.56±37.26 min）、失血量（68.78±103.31 ml）、平均住院时间（2.39±1.20 d）和术后颈椎稳定性]。此外，我们发现术后并发症发生率为 4.9%，可能发生的并发症类型。
后路微创技术是治疗颈椎病的一种有效、安全的方法，对于单节段脊髓型颈椎病和神经根型颈椎病，是一种推荐的可选手术方法。
