颈椎间孔狭窄症内镜循椎弓根减压△

Endoscopic along- pedicular decompression for cervical foraminal stenosis

摘要:

[目的]探讨经皮内镜循椎弓根减压术治疗颈椎间孔狭窄症的临床疗效。[方法]回顾性分析 2021 年 6 月—2022 年 6 月采用经皮内镜循椎弓根减压术治疗的 47 例颈椎间孔狭窄症患者的临床资料，评价临床及影像结果。[结果]47 例患者均顺利完成手术，手术时间平均 （58.8±21.2） min，术中失血量平均 （17.5±8.2） ml，术后切口愈合均良好。随访时间平均 （8.2± 4.5） 个月，与术前相比，术后次日及末次随访时，患者颈肩痛疼痛视觉模拟评分 （visual analogue scale, VAS） [(5.1±1.4), (0.8± 1.2), (0.4±0.7), P＜0.05]、上肢痛 VAS 评分 [(5.1±1.4), (0.5±0.8), (0.2±0.6), P＜0.05]、颈椎功能障碍指数 （neck disability index, NDI） [(24.9±4.8), (2.4±2.6), (1.2±1.2), P＜0.05] 均显著减少。影像方面，与术前相比，术后次日及末次随访时，椎间孔内口与椎间孔纵轴垂直距离 （internal foraminal diameter, IFD） [(3.5±1.1) mm, (4.6±1.1) mm, (4.3±2.2) mm, P＜0.05]、椎间孔中口与椎间孔纵轴垂直距离（middle foraminal diameter, MFD）[(3.4±1.2) mm, (4.5±1.3) mm, (4.4±2.5) mm, P＜0.05] 显著增加，椎间孔外口与椎间孔纵轴垂直距离 （distal foraminal diameter, DFD） 及椎间孔高度 （foraminal height, FH） 无显著变化 （P＞0.05）。[结论] 内镜循椎弓根减压术治疗颈椎间孔狭窄症安全可靠，临床疗效满意，对椎间孔内口、中口减压充分。

Abstract:

[Objective] To investigate the clinical outcomes of percutaneous endoscopic along-pedicular decompression for cervical fo- raminal stenosis. [Methods] A retrospective study was conducted on 47 patients who received percutaneous endoscopic along-pedicular de- compression for cervical foraminal stenosis from June 2021 to June 2022. The clinical and imaging results were evaluated. [Results] All the 47 patients were successfully operated on, with the average operation time of (58.8±21.2) min, the average intraoperative blood loss of (17.5±8.2) ml, and the good incision healing. As time went during the follow-up period lasted for (8.2±4.5) months on an average, at the time points preoperatively, next day after operation and the latest follow- up, the visual analogue scale (VAS) of neck and shoulder pain [(5.1±1.4), (0.8±1.2), (0.4±0.7), P＜0.05], VAS score for upper limb pain [(5.1±1.4), (0.5±0.8), (0.2±0.6), P＜0.05], neck disability index (NDI) [(24.9±4.8), (2.4±2.6), (1.2±1.2), P＜0.05] significantly decreased. In terms of imaging, compared with those before surgery, the longi- tudinal foraminal diameter (IFD) [(3.5±1.1) mm, (4.6±1.1) mm, (4.3±2.2) mm, P＜0.05], the middle foraminal diameter r (MFD) [(3.4±1.2) mm, (4.5±1.3) mm, (4.4±2.5) mm, P＜0.05] significantly increased, while the distal foraminal diameter (DFD) and foraminal height (FH) re- mained unchanged the next day after operation and the latest follow-up (P＞0.05). [Conclusion] Endoscopic along-pedicle decompression for cervical foraminal stenosis is safe and reliable, with satisfactory clinical efficacy, and sufficient decompression of the internal and mid- dle foraminal outlets.