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微创后路颈椎侧方入路减压术与前路颈椎间盘切除融合术治疗单节段单侧神经根型颈椎病的比较。

Minimally invasive posterior cervical foraminotomy vs. anterior cervical discectomy and fusion in the treatment of patients with single-level unilateral cervical radiculopathy.

机构信息

School of Graduates, Dalian Medical University, Dalian City, Liaoning Province, China.

出版信息

Eur Rev Med Pharmacol Sci. 2024 Jul;28(14):3982-3992. doi: 10.26355/eurrev_202407_36573.

DOI:10.26355/eurrev_202407_36573
PMID:39081148
Abstract

OBJECTIVE

The aim of this study was to observe the clinical efficacy and safety of minimally invasive posterior cervical foraminotomy (MI-PCF) and anterior cervical discectomy and fusion (ACDF) in the treatment of single-level unilateral cervical radiculopathy (SLUCR).

PATIENTS AND METHODS

We retrospectively analyzed 81 patients with SLUCR in two hospitals from February 2020 to February 2022, including the MI-PCF group (n=40) and the ACDF group (n=41). The differences in neck and shoulder pain, visual analog score (VAS), upper limb radiating pain (VAS), and neck disability index (NDI) were compared. Operative time, intraoperative bleeding, hospital stay, and complications were also compared between the two groups.

RESULTS

The degree of neck and shoulder pain relief at 1 day postoperatively was better in the ACDF group than in the MI-PCF group (p<0.05), while there were no significant differences between the two groups in terms of neck and shoulder pain relief at 1 month, 3 months, 6 months, and 12 months postoperatively, (p>0.05). There were no significant differences in the relief of upper limb radiating pain and the decrease of NDI scores between the two groups at 1 day, 1 month, 3 months, 6 months, and 12 months after surgery (p>0.05). The patients in MI-PCF group had shorter operative time, less bleeding, and shorter hospital stay, which were statistically different (p<0.05). There was no statistical difference in the complication rate between the two groups, (p>0.05).

CONCLUSIONS

The clinical efficacy and safety of MI-PCF and ACDF in the treatment of SLUCR are satisfactory, meanwhile, MI-PCF has shorter operative time, less bleeding and shorter hospital stay than ACDF, which is worthy of clinical promotion.

摘要

目的

本研究旨在观察微创颈椎侧方入路减压术(MI-PCF)与颈椎前路椎间盘切除融合术(ACDF)治疗单节段单侧神经根型颈椎病(SLUCR)的临床疗效及安全性。

方法

回顾性分析 2020 年 2 月至 2022 年 2 月于我院和另一医院收治的 81 例单节段单侧神经根型颈椎病患者的临床资料,其中 MI-PCF 组 40 例,ACDF 组 41 例。比较两组患者的颈肩部疼痛、视觉模拟评分(VAS)、上肢放射痛(VAS)、颈椎功能障碍指数(NDI)评分的差异,比较两组患者的手术时间、术中出血量、住院时间及并发症。

结果

术后 1 天 ACDF 组患者的颈肩部疼痛缓解程度优于 MI-PCF 组(p<0.05),但两组患者术后 1 个月、3 个月、6 个月、12 个月的颈肩部疼痛缓解程度比较差异无统计学意义(p>0.05);两组患者术后 1 天、1 个月、3 个月、6 个月、12 个月的上肢放射痛缓解程度和 NDI 评分降低程度比较差异均无统计学意义(p>0.05)。MI-PCF 组患者的手术时间更短、术中出血量更少、住院时间更短,差异有统计学意义(p<0.05)。两组患者的并发症发生率比较差异无统计学意义(p>0.05)。

结论

MI-PCF 与 ACDF 治疗 SLUCR 的临床疗效及安全性均满意,MI-PCF 具有手术时间短、术中出血量少、住院时间短等优点,值得临床推广。

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