Liu Junlin, Kong Qingquan, Feng Pin, Zhang Bin, Hu Yuan, Ma Junsong
Department of Orthopedics Surgery, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Reigion, Chengu Sichuan.
West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2022 Oct 17;9:1029028. doi: 10.3389/fsurg.2022.1029028. eCollection 2022.
To explore the clinical effect and operating skills of channel assisted Cervical Key Hole technology combined with Ultrasonic Bone Osteotome (CKH-UBO) in the treatment of single segment cervical spondylotic radiculopathy (CSR).
From June 2018 to June 2020, 14 patients diagnosed with CSR and treated with channel assisted CKH-UBO were collected. The duration of the disease, the length of the incision, the operation time, the amount of bleeding during the operation, the length of hospitalization and the complications were recorded. The Range Of Motion (ROM) and the stability of the surgical segment were recorded before and after the operation. Visual analog scale (VAS), neck disability index (NDI) and modified macnab efficacy evaluation criteria were used to evaluate the surgical efficacy.
The operative segments of the enrolled patients were all lower cervical vertebrae. The average incision length was 2.0 ± 0.1 cm, the operation time was 42.2 ± 5.7 min, the intraoperative bleeding volume was 32.7 ± 4.1 ml, and the hospital stay was 5.6 ± 1.2 days. There was no difference in ROM between preoperative and 3 months and 1 year after operation ( > 0.05), and all patients did not have segmental instability. The VAS scores of neck pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 5.6 ± 1.2, 1.6 ± 0.6, 1.1 ± 0.7, 0.6 ± 0.5, and the VAS scores of upper limb pain were 6.2 ± 1.2, 1.7 ± 0.7, 1.1 ± 0.6, 0.6 ± 0.5. The NDI scores of upper limb pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 36.7 ± 3.5, 9.8 ± 2.4, and 3.9 ± 1.5, 1.8 ± 1.0, The VAS and NDI scores at all follow-up time points after operation were significantly lower than those before operation ( < 0.001). One year after operation, the curative effect was evaluated according to the modified macnab evaluation standard, and the excellent and good rate was 100%. The complication rate was 6.25%.
Channel assisted CKH-UBO for single segment CSR has the advantages of short operation time, reliable clinical effect, high safety and low complication rate, which is worthy of clinical promotion.
探讨通道辅助颈椎钥匙孔技术联合超声骨刀(CKH-UBO)治疗单节段神经根型颈椎病(CSR)的临床疗效及手术技巧。
收集2018年6月至2020年6月诊断为CSR并采用通道辅助CKH-UBO治疗的14例患者。记录病程、切口长度、手术时间、术中出血量、住院时间及并发症。记录手术前后的活动范围(ROM)及手术节段的稳定性。采用视觉模拟评分法(VAS)、颈部功能障碍指数(NDI)及改良Macnab疗效评价标准评估手术疗效。
纳入患者的手术节段均为下颈椎。平均切口长度为2.0±0.1 cm,手术时间为42.2±5.7 min,术中出血量为32.7±4.1 ml,住院时间为5.6±1.2天。术前与术后3个月及1年的ROM无差异(>0.05),所有患者均无节段性不稳定。术前、术后3天、术后3个月及术后1年的颈部疼痛VAS评分分别为5.6±1.2、1.6±0.6、1.1±0.7、0.6±0.5,上肢疼痛VAS评分分别为6.2±1.2、1.7±0.7、1.1±0.6、0.6±0.5。术前、术后3天、术后3个月及术后1年的上肢疼痛NDI评分分别为36.7±3.5、9.8±2.4、3.9±1.5、1.8±1.0,术后各随访时间点的VAS和NDI评分均显著低于术前(<0.001)。术后1年,根据改良Macnab评价标准评估疗效,优良率为100%。并发症发生率为6.25%。
通道辅助CKH-UBO治疗单节段CSR具有手术时间短、临床效果可靠、安全性高、并发症发生率低等优点,值得临床推广。