超声引导下针刀松解术辅助经皮颈椎间盘切除术治疗神经根型颈椎病的临床观察。

Clinical observation of ultrasound-guided acupotomy assisting percutaneous cervical disc nucleoplasty in the treatment of cervical spondylotic radiculopathy.

机构信息

Department of Orthopedics, (, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China).

Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China), (, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.

出版信息

Zhen Ci Yan Jiu. 2024 Jun 25;49(6):604-610. doi: 10.13702/j.1000-0607.20230255.

DOI:10.13702/j.1000-0607.20230255

PMID:38897804

Abstract

OBJECTIVES

To observe the clinical efficacy and safety of ultrasound-guided acupotomy in adjuvant treatment of residual symptoms after percutaneous cervical disc nucleoplasty (PCDN) for cervical spondylotic radiculopathy (CSR).

METHODS

A total of 70 CSR patients were divided into treatment group and control group according to random number table, with 35 cases in each group. Patients in the control group received PCDN, while patients in the treatment group further received ultrasound-guided acupotomy, which was performed once every 5 to 7 days for a total of 4 to 6 times (adjusted according to the condition of patients). The visual analog score (VAS), neck dysfunction index (NDI), Japanese Orthopaedic Association cervical spondylosis scale (JOA score), and Tanaka Yasuhisa 20-point scale were adopted in the assessment before PCDN and 1 day, 1 month, 3 months, 6 months after PCDN. The clinical efficacy, postoperative adverse reactions and complications of the 2 groups were evaluated.

RESULTS

Compared with those before PCDN, the VAS score and NDI score of the 2 groups were decreased (<0.05), JOA score and Tanaka Yasuhisa 20-point score were increased (<0.05) at 1 day and 1, 3 and 6 months after surgery. Compared with same group 1 day after surgery, the VAS score and NDI score of the treatment group were decreased (<0.05), while JOA score and Tanaka Yasuhisa 20-point score were increased (<0.05) at 1, 3 and 6 months after surgery. Compared with the control group at the same time points, the VAS score and NDI score of the treatment group were decreased (<0.05), while JOA score and Tanaka Yasuhisa 20-point score were increased (<0.05) at 1, 3 and 6 months after operation. The effective rate and excellent rate of the treatment group 1, 3 and 6 months after PCDN were higher than those of the control group (<0.05). Follow-up to 1 year after surgery, no significant postoperative adverse reactions and complications were found in both groups.

CONCLUSIONS

Ultrasound-guided acupotomy can significantly improve the residual symptoms after PCDN for CSR patients, and the clinical efficacy is significantly better than that of PCDN alone, and this therapy is safe and reliable.

摘要

目的

观察超声引导下针刀松解术辅助治疗颈椎间盘髓核摘除术（PCDN）后残余症状对神经根型颈椎病（CSR）的临床疗效和安全性。

方法

将 70 例 CSR 患者按随机数字表法分为治疗组和对照组，每组 35 例。对照组患者行 PCDN，治疗组患者在此基础上行超声引导下针刀松解术，每 5~~7 天行 1 次，共 4~~6 次（根据患者病情调整）。采用视觉模拟评分（VAS）、颈功能障碍指数（NDI）、日本骨科协会颈椎病评分（JOA 评分）和 Tanaka Yasuhisa 20 分法评估 PCDN 前及 PCDN 后 1 天、1 个月、3 个月、6 个月时的临床疗效、术后不良反应及并发症。

结果

与 PCDN 前比较，2 组患者的 VAS 评分和 NDI 评分降低（<0.05），JOA 评分和 Tanaka Yasuhisa 20 分法评分升高（<0.05）；与术后 1 天比较，治疗组患者的 VAS 评分和 NDI 评分降低（<0.05），JOA 评分和 Tanaka Yasuhisa 20 分法评分升高（<0.05）；与同期对照组比较，治疗组患者的 VAS 评分和 NDI 评分降低（<0.05），JOA 评分和 Tanaka Yasuhisa 20 分法评分升高（<0.05）。PCDN 后 1、3、6 个月时，治疗组患者的有效率和优良率均高于对照组（<0.05）。术后随访 1 年，2 组患者均未出现明显的术后不良反应及并发症。