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分区法椎间孔切开在颈椎后路内镜手术中的应用

摘要点击次数: 2272 全文下载次数: 779 投稿时间：2019-09-19

作者	Author	单位	Address	E-Mail
常晓盼	CHANG Xiao-pan	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
梅伟	MEI Wei	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
杨勇	YANG Yong	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China	393984019@qq.com
孙宜保	SUN Yi-bao	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
李文祥	LI Wen-xiang	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
孟亚珂	MENG Ya-ke	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
陈爽	CHEN Shuang	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China
代耀军	and DAI Yao-jun	河南大学附属郑州市骨科医院, 河南郑州 450000	Zhengzhou Orthopaedics Hospital Affiliated to Henan University, Zhengzhou 450000, Henan, China

期刊信息：《中国骨伤》2020年，第33卷，第5期，第426-429页

DOI：10.12200/j.issn.1003-0034.2020.05.007

基金项目:

中文摘要:

目的：探讨分区法椎间孔切开在颈椎后路内镜手术中应用的安全性、有效性、可重复性。

方法：自2016年3月至2018年10月采用内镜下分区法椎间孔切开、髓核摘除术治疗神经根型颈椎病21例，男13例，女8例，年龄35~56（47.3±5.1）岁。手术节段：C_4，5 6例，C_5，6 10例，C_6，7 5例。采取分区法在内镜下完成椎间孔切开，再行髓核摘除及神经根减压。记录手术时间、术中出血量、手术并发症；比较术前、术后1 d、术后1周的NDI及VAS评分。

结果：所有患者顺利完成手术，手术时间为（46.10±26.39）min，术中出血量为（50.10±18.25）ml，无神经损伤、硬膜撕裂、椎动脉损伤等并发症发生。21例患者术后均获随访，时间3~9个月，中位数6个月。疼痛视觉模拟评分（visual analogue scale，VAS）及颈椎功能障碍指数（Neck Disability Index，NDI）评分手术前后有明显改善（P<0.05）；术后1 d、术后1周VAS评分差异也存在统计学意义（P<0.05）；术后1 d、术后1周NDI评分差异无统计学意义。

结论：颈椎后路内镜下应用分区法行椎间孔切开安全性高、临床疗效可靠、可重复性高。

【关键词】神经根型颈椎病内窥镜检查椎间孔切开术

Application of “Zoning Method” foraminotomy in posterior cervical endoscopic surgery

ABSTRACT

Objective: To explore the safety,effectiveness and consistency of "Zoning Method" foraminotomy in posterior cervical endoscopic surgery.

Methods: From March 2016 to October 2018,21 patients with cervical spondylotic radiculopathy were enrolled. Endoscopic foraminotomy and nucleus pulposus enucleation were performed in the patients. There were 13 males and 8 females,aged from 35 to 56 years old with an average of(47.3±5.1) years. The surgical segment of 6 cases were C_4,5,10 cases were C_5,6 and 5 cases were C_6,7. The "Zoning Method" was proposed and used to complete the foraminotomy under endoscope,and then to perform nucleus pulposus removal and nerve root decompression. The operation length,intraoperative bleeding volume and complications were recorded,and NDI,VAS were evaluated before operation,1 day after the operation and 1 week after the operation.

Results: All the operations were successful. The operation length was(46.10±26.39) min,intraoperative bleeding volume was (50.10±18.25) ml,and there were no complications such as nerve injury,dural tear or vertebral artery injury. All 21 patients were followed up for 3 to 9 months,with a median of 6 months. Postoperative VAS and NDI were obvious improved (P<0.05);there was significant difference in VAS between postoperative 1 d and 1 week(P<0.05);and there was no significant difference in NDI between postoperative 1 d and 1 week(P>0.05).

Conclusion: Endoscopic foraminotomy with "Zoning Method" is safe clinically significant,and consistent.

KEY WORDS Cervical spondylotic radiculopathy Endoscopic Foraminotomy

引用本文，请按以下格式著录参考文献：

中文格式:	常晓盼,梅伟,杨勇,孙宜保,李文祥,孟亚珂,陈爽,代耀军.分区法椎间孔切开在颈椎后路内镜手术中的应用[J].中国骨伤,2020,33(5):426~429
英文格式:	CHANG Xiao-pan,MEI Wei,YANG Yong,SUN Yi-bao,LI Wen-xiang,MENG Ya-ke,CHEN Shuang,and DAI Yao-jun.Application of “Zoning Method” foraminotomy in posterior cervical endoscopic surgery[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(5):426~429

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