后路颈椎全内镜技术治疗伴有椎间孔骨性狭窄的神经根型颈椎病:一项回顾性研究。
Posterior cervical full-endoscopic technique for the treatment of cervical spondylotic radiculopathy with foraminal bony stenosis: A retrospective study.
作者信息
Shi Meng, Wang Cong, Wang Huihao, Ding Xiaoqing, Feng Juntao, Zhou Lin, Cai Yuwei, Yu Zhongxiang
机构信息
Department of Orthopaedics, ShuGuang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Radiology, ShuGuang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
出版信息
Front Surg. 2023 Jan 4;9:1035758. doi: 10.3389/fsurg.2022.1035758. eCollection 2022.
OBJECTIVE
In the treatment of cervical spondylotic radiculopathy (CSR), spinal endoscopy has been developed vigorously in the past 30 years. However, its effectiveness and subsequent problem of cervical spine stability have always been the controversial hotspots. This study aims to conduct a retrospective study using posterior cervical full-endoscopic technique for the treatment of CSR with foraminal bony stenosis, and evaluate its clinical effect and application value.
METHODS
All 22 patients treated for CSR with foraminal bony stenosis using posterior cervical full-endoscopic technique were analyzed since Dec 1, 2016, to Apr 30, 2020. The data collection included operation time, length of stay, wound healing, surgical complications, visual analog scale (VAS), Japanese Orthopaedic Association (JOA) scores, intervertebral foramen diameter, intervertebral foramen area and cervical instability. The relevant indicators were observed on admission, at postoperative 1 week and 3 months, and at the last follow-up.
RESULTS
The operation time was 141.6 ± 13.7 min. The length of stay was 6.0 ± 2.5 days. VAS and JOA at different time points after operation were decreased compared with before operation (< 0.05). There were no statistical differences between VAS or JOA at different postoperative time points (> 0.05). The height, anteroposterior diameter and area of intervertebral foramen after operation were significantly increased compared with before operation (< 0.05).
CONCLUSION
Posterior cervical full-endoscopic technique shows the advantages of smaller invasion, faster recovery, significant effectiveness and fewer complications in our study. Meanwhile, it has little influence on the ROM and stability of the cervical spine. Therefore, it is a minimally invasive, safe and effective surgical method for the treatment of CSR with foraminal bony stenosis.
目的
在神经根型颈椎病(CSR)的治疗中,脊柱内镜在过去30年中得到了蓬勃发展。然而,其疗效以及随后颈椎稳定性的问题一直是有争议的热点。本研究旨在采用颈椎后路全内镜技术对伴有椎间孔骨性狭窄的CSR进行回顾性研究,并评估其临床效果及应用价值。
方法
分析自2016年12月1日至2020年4月30日采用颈椎后路全内镜技术治疗伴有椎间孔骨性狭窄的CSR的22例患者。数据收集包括手术时间、住院时间、伤口愈合情况、手术并发症、视觉模拟评分(VAS)、日本骨科学会(JOA)评分、椎间孔直径、椎间孔面积和颈椎稳定性。在入院时、术后1周和3个月以及末次随访时观察相关指标。
结果
手术时间为141.6±13.7分钟。住院时间为6.0±2.5天。术后不同时间点的VAS和JOA评分与术前相比均降低(<0.05)。术后不同时间点的VAS或JOA评分之间无统计学差异(>0.05)。术后椎间孔的高度、前后径和面积与术前相比均显著增加(<0.05)。
结论
在本研究中,颈椎后路全内镜技术显示出侵袭性小、恢复快、疗效显著和并发症少的优点。同时,它对颈椎的活动度和稳定性影响较小。因此,它是治疗伴有椎间孔骨性狭窄的CSR的一种微创、安全有效的手术方法。