全内镜脊柱手术治疗脊髓型颈椎病：系统评价。
Full Endoscopic Spine Surgery for Cervical Spondylotic Myelopathy: A Systematic Review.
机构信息
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedics, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan.
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedics, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan.
出版信息
World Neurosurg. 2023 Jul;175:142-150. doi: 10.1016/j.wneu.2023.05.012. Epub 2023 May 9.
BACKGROUND
Cervical spondylotic myelopathy (CSM) may seriously affect quality of life. In the literature, there is scarce evidence of the pros and cons of full endoscopic spine surgery in the treatment of CSM. The main purpose of this study was to conduct a systematic review to elucidate the efficacy of full endoscopic spine surgery in the management of patients with CSM.
METHODS
This systematic review was conducted in accordance with the PRISMA guidelines. A systematic search of Web of Science, PubMed MEDLINE, Embase, and Cochrane Library was conducted from the database inception to February 1, 2023.
RESULTS
The study included 183 patients and their age was 56.78 ± 7.87 years. The average surgical time calculated was 96.34 ± 33.58 minutes. Intraoperative blood loss ranged from a minimal amount to 51 mL. The average duration of hospital stay was 3.56 ± 1.6 days. The average span for follow-up was on an interval of 18.7 ± 6.76 months. Significant improvements were noted in all aspects of functional outcomes and image results after full endoscopic cervical spine surgery, with no major complications.
CONCLUSIONS
The current study found that both anterior transcorporeal and posterior surgical approaches could be used for the treatment of CSM with a full endoscopic technique. Indications of full endoscopic cervical spine surgery for CSM included cervical disc herniation, central canal stenosis, calcified ligamentum flavum, and ossification of the posterior longitudinal ligament. Improved postoperative outcomes with acceptable surgical complications were noted in this systematic review.
背景
颈椎脊髓病（CSM）可能严重影响生活质量。在文献中，全内镜脊柱手术治疗 CSM 的优缺点证据不足。本研究的主要目的是进行系统评价，阐明全内镜脊柱手术治疗 CSM 患者的疗效。
方法
本系统评价按照 PRISMA 指南进行。从数据库建立到 2023 年 2 月 1 日，对 Web of Science、PubMed MEDLINE、Embase 和 Cochrane Library 进行了系统检索。
结果
研究纳入了 183 例患者，年龄为 56.78 ± 7.87 岁。计算的平均手术时间为 96.34 ± 33.58 分钟。术中出血量从微量到 51 mL 不等。平均住院时间为 3.56 ± 1.6 天。平均随访时间为 18.7 ± 6.76 个月。全内镜颈椎手术后，所有功能结果和影像学结果均有显著改善，无重大并发症。
结论
本研究发现，全内镜技术可用于治疗 CSM 的前路经椎体和后路手术。全内镜颈椎手术治疗 CSM 的适应证包括颈椎间盘突出症、中央管狭窄症、钙化黄韧带和后纵韧带骨化症。本系统评价中，术后结果改善，手术并发症可接受。
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