显微内镜下颈椎后路椎间孔切开减压术的疗效探讨.doc

显微内镜下颈椎后路椎间孔切开减压术的疗效探讨

2010 5 24 5
中国修复重建外科杂志年月第卷第期 513
?? ??
? 脊柱修复与功能重建?
显微内镜下颈椎后路椎间孔切开减压术的疗效探讨
1 1# 2 1 1 1
彭明戚超吕道静曹新峰彭国栋马晓程
【摘? 要】目的探讨显微内镜下颈椎后路椎间孔切开减压术治疗神经根型颈椎病及颈椎间盘突出症的临床
疗效。方法 2004 年2 月-2007 年6 月,于显微内镜下行颈椎后路椎间孔切开减压术24 例。男 16 例,女8 例;年龄
42 ~68 岁,平均59 岁。其中神经根型颈椎病16 例,颈椎间盘突出症8 例。病变节段:C4 、5 8 例,C5、6 12 例,C6、7 4 例。
病程6 ~15 个月。影像学检查显示8 例颈椎间盘突出症中软性突出物6 例、硬性突出物2 例;神经根型颈椎病的受压因
素主要为黄韧带肥厚、钩椎关节增生及关节突关节位置异常。根据日本骨科协会(JOA )脊髓功能评分法评定为( ±
)分。? 结果手术时间90 ~120 min,平均100 min ;术中出血量100 ~150 mL,平均120 mL 。1 例全麻手术患
者术中为切除钙化的突出髓核组织造成神经根牵拉伤,术后采用甲泼尼龙冲击治疗后3 个月神经根功能恢复;其余患
者术后神经根疼痛症状明显改善 19 例,减轻4 例。术后影像学检查显示手术部位减压彻底。24 例均获随访,随访时间
24 ~36 个月,平均28 个月。X 线片及CT 检查示椎间高度无明显丢失,生理曲度正常。术后24 个月根据JOA 脊髓功能
评分法评定为( ± )分,与术前比较差异有统计学意义(P )。结论显微内镜下颈椎后路椎间孔切开减
压术可通过小切口快捷进入术区,减少了组织损伤,避免了椎间高度丢失,临床疗效优良。
【关键词】显微内镜神经根型颈椎病颈椎间盘突出? ? 椎间孔切开减压术
中图分类号:? 文献标志码:A
EFFICACY OF POSTERIOR MICROENDOSCOPIC FORAMINOTOMY FOR CERVICAL RADICULOPATHY/PENG
1 1 2 1 1 1 1
Ming , QI Chao , LV Daojing , CAO Xinfeng , PENG Guodong , MA Xiaocheng . Department of Orthopaedics, the Qingdao
Municipal Hospital Affiliated to Qingdao University, Qingdao Shandong, 266011, ; 2Department of Anesthesics, the
People’s Hospital of Chengyang District of Qingdao City. Corresponding author: QI Chao, E-mail: ******@yahoo
【Abstract 】 Objective To evaluate the clinical results of posterior microendoscopic foraminotomy in the treament
of cervical radiculopathy and cervical intervertebral disc protrusion. Methods From February 2004 to June 2007, 24 cases
of cervical radiculopathy received posterior microendoscopic foraminotomy. There were 16 males and 8 females, aging 42-68
years 59 years on average , including 16 cases of cervical radiculopathy and 8 cases of cervical intervertebral disc protrusion.
The course of disease was 6-15 months. The affected intervertebral discs were C4, 5 in 8 cases, C5, 6 in 12 cases, and C6, 7 in 4
ca