低温等离子髓核消融术治疗神经根型颈椎病的中期临床疗效观察

发布时间：2018-06-30 06:33

  本文选题：低温等离子髓核消融术 + 神经根型颈椎病　； 参考：《中国微创外科杂志》2017年05期

【摘要】：目的观察低温等离子髓核消融术(percutaneous cervical disc nucleoplasty,PCDN)治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的中期临床疗效。方法 2010年4月~2013年6月我科采用PCDN在局麻和影像学监视下靶向穿刺,消融及热凝(射频能量100 Hz)治疗CSR 231例,其中135例获得2年以上随访,采用日本整形外科田中靖久(Yasuhisa Tanaka)的症状量化表20分法(简称YT 20分法)、改良Mac Nab评分法对术后1、3、6、12、24个月和末次随访的疗效进行评价。结果均为单节段手术,其中C_(4~5)32例,C_(5~6)64例,C_(6~7)39例。术后未发生神经根损伤、大血管破裂、穿刺点感染及椎间隙感染等并发症。135例门诊随访2~5年1个月,中位数3.2年。术后1、3、6、12、24个月YT 20评分分别为(14.35±4.47),(14.82±4.94),(15.71±5.43),(15.77±5.56),(15.29±5.64)分,均较术前(8.87±4.29)分明显提高(P均=0.000);术后1、3、6、12、24个月YT 20分法优良率分别为47.4%(64/135)、57.0%(77/135)、65.9%(89/135)、65.2%(88/135)、61.5%(83/135),有效率分别为77.0%(104/135)、78.5%(106/135)、77.0%(104/135)、74.8%(101/135)、71.9%(97/135),术后3、6、12、24个月YT 20分法疗效均明显优于术后1个月(P0.05)。术后复发27例,占20.0%(27/135)。术后1、3、6、12、24个月改良Mac Nab疗效评价,优良率分别为64.4%(87/135)、65.2%(88/135)、70.4%(95/135)、67.4%(91/135)、64.4%(87/135),有效率分别为85.2%(115/135)、85.2%(115/135)、83.0%(112/135)、80.7%(109/135)和78.5%(106/135);术后3、6、12个月改良Mac Nab疗效均明显优于术后1个月(P0.05),术后6、12个月分别优于术后3、24个月(P0.05)。结论 PCDN能明显改善CSR患者颈肩背部及上肢酸胀、疼痛、麻木等症状,提高患者的日常生活与工作能力,中期疗效满意。
[Abstract]:Objective to observe the intermediate clinical effect of hypothermia plasma ablation (percutaneous cervical disc) on (cervical spondylotic radiculopathy (cervical spondylotic) of cervical spondylosis. Methods from April 2010 to June 2013, 231 cases of CSR were treated with PCDN under the surveillance of local anesthesia and imaging monitoring. Among them, 135 cases were followed up for more than 2 years. The modified Mac-Nab scoring method was used to evaluate the curative effect of 12 months, 24 months and the last follow-up of Yasuhisa Tanaka, a Japanese plastic surgery, with the modified Mac Nab scoring method. Results all of them were single segmental operation, of which 32 cases were C4F5, 64 cases were C6, and 39 cases were C6F7. There were no complications such as nerve root injury, major vascular rupture, puncture site infection and intervertebral space infection. 135 cases were followed up for 2 ~ 5 years and 1 month, median 3.2 years. 鏈�鍚�1,3,6,12,24涓�鏈圷T 20璇勫垎鍒嗗埆涓，

本文编号：2085327