经后路脊柱内镜下椎间孔扩大成形减压术治疗神经根型颈椎病

摘要

目的:探讨经后路脊柱内镜下椎间孔扩大成形减压术治疗神经根型颈椎病的适应证及疗效.方法:选取于2013年5月至2016年5月间就诊于我院的56例神经根型颈椎病病人,在C形臂X线机引导下行经后路脊柱内镜下椎间孔成形减压术.评价治疗前后病人椎间高度、颈椎曲度、视觉模拟评分法(visual analogue scale,VAS)及日本矫形外科学(Japanese Orthopaedic Association,JOA)评分.结果:手术后病人颈椎曲度测量值较手术前显著增加(P<0.01),手术前后病变椎间高度无明显变化(P>0.05),手术后病人VAS评分较前明显下降,JOA评分治疗后较治疗前有明显的提高(P<0.01).结论:经后路脊柱内镜下椎间孔切开减压术可有效改善颈椎间盘突出症所致的上肢运动功能及感觉障碍,临床疗效确切,且手术安全、并发症少.%Objective: To investigate the indication and curative effects of discectomy cervical foraminotomy though percutaneous posterior transforaminal endoscopic for the treatment of cervical spondylotic radiculopathy. Methods: A group of 56 patients of cervicalspondylotic radiculopathy received the C arm X-ray machine guided discectomy cervical foraminotomy through percutaneous posterior transforaminal endoscopic from May 2013 to May 2016. The intervertebral height, cervical curvature, VAS and JOA scores were evaluated before and post surgery. Results: The cervical curvature measurements of the patients after operation increased significantly than before the surgery (P < 0.01), there were no significant changes in the height of intervertebral disc lesion before and after surgery (P > 0.05), VAS scores after surgery in patients decreased significantly, JOA scores after treatment increased significantly than before treatment (P <0.01). Conclusion: Discectomy cervical foraminotomy through the percutaneous posterior transforaminal endoscopic can effectively improve upper limb motor function and sensory disorders caused by the cervical spondylotic radiculopathy, with relative safety and fewer complications.