Tomaras C R, Blacklock J B, Parker W D, Harper R L
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030, USA.
J Neurosurg. 1997 Jul;87(1):41-3. doi: 10.3171/jns.1997.87.1.0041.
A series of 200 patients who underwent outpatient surgical treatment for cervical radiculopathy is presented. The patients were selected on the basis of their willingness to undergo surgery in the outpatient setting and the absence of serious underlying medical conditions. All operations were performed using general anesthetic techniques with limited posterior dissections. A laminoforaminotomy was performed at each affected level, which had been determined by preoperative imaging and clinical examination. After being observed for several hours, the patients were discharged if they met specific criteria. No patient required subsequent hospital admission in the immediate postoperative period. Follow-up review in 183 patients ranged from 3 to 43 months, with a mean of 19 months. In cases in which Workers' Compensation claims were not involved, 92.8% of patients reported an excellent or good outcome and returned to work or comparable duties at a mean of 2.9 weeks. In cases in which Workers' Compensation claims were involved, 77.8% of patients reported excellent or good outcome and returned to work at a mean of 7.6 weeks postoperatively. Two patients whose cases involved Workers' Compensation claims did not return to work. There were seven patients (3.8%) who had a poor outcome. Two of these patients underwent a second posterior procedure and reported a good outcome at the time of follow-up review. The results of this study show that outpatient surgical treatment of cervical radiculopathy can be safely provided in selected patients with outcomes similar to the inpatient surgical management of these individuals.
本文报告了200例接受门诊手术治疗神经根型颈椎病的患者。这些患者是基于他们愿意在门诊接受手术且无严重基础疾病而入选的。所有手术均采用全身麻醉技术,后路解剖范围有限。在术前影像学检查和临床检查确定的每个受累节段进行椎板间孔切开术。观察数小时后,符合特定标准的患者即可出院。术后近期无患者需要再次住院。183例患者的随访时间为3至43个月,平均19个月。在未涉及工伤赔偿的病例中,92.8%的患者报告预后良好或优秀,并在平均2.9周后恢复工作或从事类似工作。在涉及工伤赔偿的病例中,77.8%的患者报告预后良好或优秀,并在术后平均7.6周恢复工作。有2例涉及工伤赔偿的患者未恢复工作。有7例患者(3.8%)预后较差。其中2例患者接受了第二次后路手术,随访时报告预后良好。本研究结果表明,对于部分患者,门诊手术治疗神经根型颈椎病是安全的,其疗效与这些患者的住院手术治疗相似。