低温等离子髓核消融术治疗颈性眩晕近期临床疗效观察

发布时间：2018-06-01 12:34

本文选题：低温等离子髓核消融术 + 颈性眩晕　；参考：《中国脊柱脊髓杂志》2016年04期

【摘要】：目的:观察低温等离子髓核消融术(percutaneous cervical discnucleoplasty,PCDN)治疗颈性眩晕近期临床疗效。方法:2010年4月~2013年3月我科采用PCDN治疗颈椎病患者295例,其中颈性眩晕患者92例,61例获得2~3.9年(平均2.7±0.52年)随访,男性20例,女性41例,年龄33~81岁,平均(57.28±10.55)岁,采用改良颈性眩晕及伴随症状评估量表评价术后即刻、术后3个月、术后12个月和末次随访时的有效率。结果:所有患者术中、术后均无神经损伤、感染等并发症发生。术后即刻、术后3个月、术后12个月和末次随访时,61例患者的眩晕及伴随症状的平均改良评分分别为21.75±1.76、25.00±4.00、24.82±4.38、24.64±4.12分,均较术前(18.06±3.25分)明显上升,有效率分别为96.7%、75.4%、72.1%、72.1%。末次随访时,眩晕症状消失或明显缓解的患者占72.1%(44/61),其中治疗节段包含C3/4或C4/5节段者43例(C4/5 30例,C3/4 4例,C3/4、C4/5 9例);C5/6、C6/7 1例。4例患者于术后12个月前后眩晕症状复发,复发率占6.6%,其中3例予以保守治疗,另1例行颈椎人工间盘置换术,经治疗后症状均获得明显改善。17例随访无效的患者中,4例患者术前TCD显示椎-基底动脉狭窄或椎动脉狭窄;5例患者年龄偏高,术前均合并有高血压病3级;其他患者原因不明。结论:利用PCDN治疗颈性眩晕可以获得较好的近期临床疗效;选择C3/4和/或C4/5节段是取得疗效的关键。
[Abstract]:Objective: to observe the clinical effect of low temperature plasma nucleus pulposus ablation (cervical discnucleoplasty PCDN) in the treatment of cervical vertigo. Methods: from April 2010 to March 2013, 295 patients with cervical spondylosis were treated with PCDN. Among them, 92 patients with cervical vertigo were followed up for 2 ~ 3.9 years (mean 2.7 卤0.52 years). There were 20 males and 41 females, aged 3381 years with an average of 57.28 卤10.55 years. The efficacy of modified cervical vertigo and associated symptom assessment scale was evaluated immediately after operation, 3 months after operation, 12 months after operation and at the last follow-up. Results: no nerve injury, infection and other complications occurred in all patients during and after operation. Immediately after operation, 3 months after operation, 12 months after operation and the last follow-up, the average improvement scores of vertigo and associated symptoms in 61 patients were 21.75 卤1.76 卤25.00 卤4.00 卤24.82 卤4.38 卤24.64 卤4.12, respectively, which were significantly higher than those before operation (18.06 卤3.25). The effective rates were 96.75.45.40.72.41 and 72.1respectively. At the last follow-up, there were 72.1% of the patients who had disappeared or obviously relieved of dizziness, and 44 / 61% of them were treated with C _ 3 / 4 or C _ 4 / 5 segments, 43 cases with C _ 4 / 5 segment or C _ 4 / 5 segment C _ 4 / 30 cases with C _ 3 / 4% C _ 3 / 4 cases with C _ 3 / 4% C _ 4 / 4, 9 cases with C _ 5 / 6 C _ 6 / R _ 7, 4 cases with recurrent vertigo symptoms before and after 12 months of operation. The recurrence rate was 6.6%, of which 3 cases were treated conservatively and 1 case underwent cervical intervertebral disc replacement. After treatment, the symptoms were significantly improved. Among the 17 patients with ineffective follow-up, 4 patients with vertebrobasilar artery stenosis or vertebral artery stenosis showed that 5 patients with vertebrobasilar artery stenosis or vertebral artery stenosis had high age, and all patients had hypertension grade 3 before operation, while the other patients had unknown cause. Conclusion: the treatment of cervical vertigo with PCDN is effective in the short term, and the selection of C _ 3 / 4 and / or C _ 4 / 5 segments is the key to the treatment of cervical vertigo.
【作者单位】：北京东直门医院骨二科;
【分类号】：R687.3

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