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经皮颈椎后外侧孔内镜下颈椎板切除术治疗神经根型颈椎病的临床疗效及学习曲线。

Clinical efficacy and learning curve of posterior percutaneous endoscopic cervical laminoforaminotomy for patients with cervical spondylotic radiculopathy.

机构信息

The No.2 Department of Orthopedics, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing, China.

Department of Spinal Surgery, First Hospital of Bethune, Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30401. doi: 10.1097/MD.0000000000030401.

Abstract

In this study, we aimed to investigate the clinical efficacy and learning curve of posterior percutaneous endoscopic cervical laminoforaminotomy (PPECLF) in patients with cervical spondylotic radiculopathy (CSR). A total of 64 patients with CSR received PPECLF. Clinical outcome scores included the visual analog scale, Japanese Orthopedic Association score, neck disability index, and modified Macnab criteria. Radiological outcomes included the disc height, C2 to C7 Cobb angle, and range of motion. The learning curve was evaluated using cumulative sum analysis. Patients were divided into accumulation phase and mastery phase groups (A and B), and general data and surgical efficacy were compared between the 2 groups. Follow-up ranged from 12 to 24 months. Clinical outcome scores improved significantly at the final follow-up, and there were no differences in radiological outcomes. Surgical efficacy was excellent and good in 82.8% of patients. The operative time showed a decreasing trend with the accumulation of cases. Patients were divided and the 26th case was the cutoff point according to the learning curve. No significant differences were found in the clinical outcomes between the 2 groups. Decompression with PPECLF was safe and effective in the treatment of CSR. With the accumulation of cases, the operative time was gradually shortened, and the clinical efficacy was significant. The PPECLF procedure can be performed efficiently and safely to treat CSR.

摘要

在这项研究中,我们旨在探讨颈椎后外侧经皮内镜减压术(PPECLF)治疗神经根型颈椎病(CSR)的临床疗效和学习曲线。共 64 例 CSR 患者接受了 PPECLF 治疗。临床疗效评分包括视觉模拟评分、日本矫形协会评分、颈部残疾指数和改良 Macnab 标准。影像学结果包括椎间盘高度、C2 至 C7 Cobb 角和活动范围。学习曲线采用累积和分析进行评估。患者分为积累期和掌握期(A 组和 B 组),比较两组的一般资料和手术疗效。随访时间为 12 至 24 个月。末次随访时临床疗效评分显著改善,影像学结果无差异。手术疗效优良率为 82.8%。手术时间随病例积累呈下降趋势。根据学习曲线,将患者分为两组,第 26 例为截止点。两组间临床疗效无显著差异。PPECLF 减压治疗 CSR 安全有效。随着病例的积累,手术时间逐渐缩短,临床疗效显著。PPECLF 手术可有效、安全地治疗 CSR。

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