Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland).
Institute of Orthopedics of Jiangxi Province, Nanchang, Jiangxi, China (mainland).
Med Sci Monit. 2023 Dec 21;29:e942137. doi: 10.12659/MSM.942137.
BACKGROUND Key-hole surgery is a minimally invasive technique that has shown promise in various surgical procedures. This study aimed to assess the clinical effectiveness of preoperative coronal MRI-assisted key-hole surgery for the treatment of patients with cervical spondylotic radiculopathy (CSR). MATERIAL AND METHODS A total of 30 patients diagnosed with CSR and undergoing key-hole surgery with CMRI assistance were included in the study. Various parameters, including surgical segments, incision length, disease duration, operative time, intraoperative fluoroscopy times, intraoperative blood loss, complications, and length of hospitalization, were recorded. Precise measurements of Cobb angles and intervertebral space height were taken before and after the surgical procedure. Surgical outcomes were evaluated using modified Macnab criteria, visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA), and neck disability index (NDI). RESULTS The average duration of disease was 6.47±3.29 months, with an average incision length of 1.94±0.15 cm and operative time of 57.83±4.34 minutes. The average intraoperative blood loss was 33.70±9.28 ml, with an average of 3.50±0.73 intraoperative fluoroscopies. The average duration of hospitalization was 4.10±1.27 days. Preoperative and postoperative measurements showed no statistically significant difference in C2-C7 Cobb angles and intervertebral space height. However, there were significant improvements in postoperative VAS, NDI, and JOA scores compared to preoperative scores. The surgical effectiveness rate was 100%, with a high rate of good and excellent outcomes. CONCLUSIONS The findings of this study suggest that preoperative CMRI-assisted key-hole surgery for single-segment CSR is a safe and effective treatment option with low complication rates. The clinical benefits include high security and good outcomes. Further research and larger studies are warranted to validate these findings.
锁孔手术是一种微创技术,已在各种外科手术中显示出良好的效果。本研究旨在评估术前冠状 MRI 辅助锁孔手术治疗神经根型颈椎病(CSR)患者的临床疗效。
本研究共纳入 30 例经 MRI 辅助锁孔手术诊断为 CSR 的患者。记录了手术节段、切口长度、疾病持续时间、手术时间、术中透视次数、术中出血量、并发症和住院时间等各项参数。对手术前后 Cobb 角和椎间隙高度进行精确测量。采用改良 Macnab 标准、视觉模拟评分(VAS)、日本骨科协会评分(JOA)和颈部残疾指数(NDI)评估手术效果。
疾病平均持续时间为 6.47±3.29 个月,平均切口长度为 1.94±0.15cm,手术时间为 57.83±4.34 分钟。平均术中出血量为 33.70±9.28ml,术中透视次数平均为 3.50±0.73 次。平均住院时间为 4.10±1.27 天。术前和术后 C2-C7 Cobb 角和椎间隙高度测量值无统计学差异。但术后 VAS、NDI 和 JOA 评分均较术前显著改善。手术有效率为 100%,优良率高。
本研究表明,单节段 CSR 患者行术前 MRI 辅助锁孔手术是一种安全有效的治疗方法,并发症发生率低。临床获益包括高安全性和良好的疗效。需要进一步的研究和更大的研究来验证这些发现。