Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Pain Physician. 2022 Oct;25(7):E1087-E1094.
Percutaneous cervical nucleoplasty (PCN) is a minimally invasive technique used for the treatment of cervical disc herniation. However, if the lesion is located at the neural foramen, complete access and effective neural decompression are often challenging because of the special anatomical condition of the uncovertebral joint, osteophyte, and facet joint of the cervical foraminal space.
To investigate the effect of PCN on radiculopathy caused by foraminal cervical disc herniation (FCDH).
Retrospective case series.
Single-center tertiary hospital.
This study included 44 patients with radiculopathy caused by FCDH who were treated with PCN. Visual analog scale (VAS) scores, preoperative, 1 week, and 3 months postoperatively, and at the last follow-up, as well as the Macnab criteria, were used to evaluate clinical outcomes. A paired t-test was used to compare the preoperative and follow-up VAS scores. The percentage of patients with VAS scores <= 3 at each follow-up time point was also investigated. Statistical significance was set at P < 0.05.
Twenty-seven men (62.4%) and 17 women (38.6%) were enrolled in this study. The mean age was 54.5 years (range 31-81). The average follow-up period after the operation was 15.4 months (range 3.7-30.8). The mean preoperative VAS was 7.50 ± 1.21. The VAS scores at 1 week, 3 months, and the last follow-up were 4.36 ± 2.46, 3.20 ± 2.58, and 2.91 ± 2.74, respectively, showing a significant improvement in pain compared to before the operation (P < 0.001 for all). The number of patients (percentage) with a VAS score of <= 3 was 20 (45.5%), 28 (63.6%), and 31 (70.5%) of 44 patients at 1 week, 3 months, and the last follow-up, respectively. The number of patients (percentage) with excellent, good, fair, or poor satisfaction according to the Macnab criteria was 17 (38.6%), 9 (20.5%), 8 (18.2%), and 10 (22.7%) of 44, respectively. No patients experienced postoperative complications.
This study was retrospective and included a small number of patients from a single center.
Although PCN for radiculopathy caused by FCDH is thought to have limitations because of the surrounding bony structure, the clinical outcome seemed favorable. If PCN is not contraindicated, it may be a viable treatment option for CR due to FCDH.
经皮颈椎间盘成形术（PCN）是一种用于治疗颈椎间盘突出症的微创技术。然而，如果病变位于神经孔，则由于颈椎神经孔空间的小关节、骨赘和关节突关节的特殊解剖条件，通常难以完全进入和有效进行神经减压。
探讨 PCN 治疗颈椎神经孔型椎间盘突出症（FCDH）所致神经根病的效果。
回顾性病例系列。
单中心三级医院。
本研究纳入了 44 例因 FCDH 导致神经根病的患者，采用 PCN 治疗。采用视觉模拟评分（VAS）评分、术前、术后 1 周和 3 个月以及末次随访时评估临床疗效，并采用 Macnab 标准进行评估。采用配对 t 检验比较术前和随访时的 VAS 评分。还研究了每个随访时间点 VAS 评分≤3 的患者比例。统计学显著性水平设为 P < 0.05。
本研究纳入 27 例男性（62.4%）和 17 例女性（38.6%）。平均年龄为 54.5 岁（范围 31-81 岁）。术后平均随访时间为 15.4 个月（范围 3.7-30.8 个月）。术前 VAS 平均为 7.50±1.21。术后 1 周、3 个月和末次随访时 VAS 评分分别为 4.36±2.46、3.20±2.58 和 2.91±2.74，与术前相比疼痛明显改善（均 P < 0.001）。44 例患者中，术后 1 周、3 个月和末次随访时 VAS 评分≤3 的患者分别为 20 例（45.5%）、28 例（63.6%）和 31 例（70.5%）。根据 Macnab 标准，术后 1 周、3 个月和末次随访时优、良、可和差的患者分别为 17 例（38.6%）、9 例（20.5%）、8 例（18.2%）和 10 例（22.7%）。无患者出现术后并发症。
本研究为回顾性研究，且仅纳入了来自单一中心的少量患者。
虽然由于周围骨结构的原因，经皮颈椎间盘成形术治疗颈椎神经孔型椎间盘突出症所致神经根病的效果可能存在局限性，但临床结果似乎较好。如果 PCN 无禁忌证，对于因 FCDH 引起的 CR，PCN 可能是一种可行的治疗选择。
