[1]李来好,夏磊,王文刚,等.后路颈椎全内镜下突出髓核摘除术治疗单节段外侧型颈椎间盘突出症[J].中医正骨,2017,29(06):62-64.
点击复制

后路颈椎全内镜下突出髓核摘除术治疗单节段外侧型颈椎间盘突出症()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年06期
页码:
62-64
栏目:
影像诊断
出版日期:
2017-06-20

文章信息/Info

作者:
李来好1夏磊2王文刚2陈艳超1王鹏程1杨贤玉1李洪珂1潘登1高振甫1
1.平煤神马医疗集团总医院,河南 平顶山 467000; 2.郑州大学第一附属医院,河南 郑州 450052
关键词:
椎间盘移位 椎间盘切除术经皮 颈椎 外科手术微创性 内窥镜检查
摘要:
目的:探讨后路颈椎全内镜下突出髓核摘除术治疗单节段外侧型颈椎间盘突出症的短期疗效。方法:2013年3月至2015年12月收治16例单节段外侧型颈椎间盘突出症患者。男9例,女7例; 年龄35~58岁,中位数43岁; C5~6椎间盘突出7例、C6~7椎间盘突出9例; 患者均有不同程度的颈肩部疼痛,9例合并单侧上肢放射性疼痛,3例合并前臂外侧放射性疼痛、麻木,4例合并单侧手指疼痛、麻木。所有患者均经6个月以上口服药物、按摩、牵引、理疗等非手术治疗,效果欠佳。均采用后路颈椎全内镜(Joimax)下突出髓核摘除术治疗,术后分别采用疼痛视觉模拟量表(visual analogue scale,VAS)和日本骨科学会(Japanese orthopaedic association,JOA)颈椎病功能评定量表(17分法)评定患者的颈肩部疼痛程度和总体疗效。结果:所有患者均顺利完成手术,未发生脊髓神经损伤。所有患者均获得随访,随访时间12~18个月,中位数14个月。术后14例患者的症状明显减轻,术前、术后1个月及术后12个月时的疼痛VAS评分分别为(8.36±0.32)分、(2.65±0.74)分、(1.26±0.24)分,JOA评分分别为(6.29±0.40)分、(12.18±0.81)分、(13.68±0.34)分; 2例患者颈肩部疼痛症状改善不明显,经局部理疗、封闭等治疗后症状改善。结论:采用后路颈椎全内镜下突出髓核摘除术治疗单节段外侧型颈椎间盘突出症,短期疗效满意。

参考文献/References:

[1] 白玉,赵灿,董良,等.非手术综合疗法治疗神经根型颈椎病150例临床观察[J].中医正骨,2014,11(11):29-31.
[2] 田浩文,高晓平.非手术脊柱减压治疗神经根型颈椎病的疗效分析[J].中华临床医师杂志:电子版,2013,7(14):6711-6713.
[3] 蔡三,高丽萍,叶嗣宽.神经根型颈椎病手术治疗26例临床疗效观察[J].中国实用外科杂志,2011,31(S2):44-45.
[4] 潘显明,邓少林,黄欣,等.脊髓型及神经根型颈椎病的前路手术治疗[J].中国矫形外科杂志,2011,19(3):243-245.
[5] 王正祥,杨子斌,阮安培,等.颈前路手术治疗神经根型颈椎病的临床研究[J].临床医学工程,2013,9(20):1139-1140.
[6] 谢林,顾军,贾晋辉,等.经皮5.9mm全内窥镜后路椎间孔切开髓核摘除治疗颈椎间盘突出症临床观察[J].现代中西医结合杂志,2013,22(10):1074-1075.
[7] 秀荣,张锟,张方璟,等.颈椎间盘突出 MRI 分型与临床表现研究[J].现代医用影像学,2015,24(5):708-710.
[8] 刘云鹏,刘沂.骨与关节损伤和疾病的诊断分类及功能评定标准[M].北京:清华大学出版社,2002:243-244.
[9] THOOMES EJ,SCHOLTEN-PEETERS GG,DE BOER AJ,et al.Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies:a systematic review[J].Eur Spine J,2012,21(8):1459-1470.
[10] RODINE RJ,VERNON H.Cervical radiculopathy:a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index[J].J Can Chiropr Assoc,2012,56(1):18-28.
[11] YUE JJ,LONG W.Full endoscopic spinal surgery techniques:advancements,indications,and outcomes[J].Int J Spine Surg,2015,9(9):17.
[12] 楚磊,陈亮,汪洋,等.后路经皮内窥镜下颈椎间盘髓核摘除术治疗颈椎间盘突出症[J].重庆医科大学学报,2014,39(2):219-222.
[13] 李进,孔维军,季文军,等.后路全内镜手术治疗单节段后外侧型颈椎间盘突出症的短期疗效观察[J].遵义医学院学报,2016,39(2):170-174.
[14] 郭骏,胡攀,任伟剑,等.后路椎间孔镜下开窗减压髓核摘除术治疗单节段神经根型颈椎病[J].中医正骨,2016,28(9):37-39.
[15] AHN Y.Percutaneous endoscopic cervical discectomy using working Channel endoscopes[J].Expert Rev Med Devices,2016,13(6):601-610.
[16] KIM CH,SHIN KH,CHUNG CK,et al.Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy[J].Global Spine J,2015,5(1):31-38.
[17] RUETTEN S,KOMP M,MERK H,et al.Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes:a prospective,randomized,controlled study [J].Spine(Phila Pa 1976),2008,33(9):940-948.
[18] RUETTEN S,KOMP M,MERK H,et al.A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes:prospective 2-year results of 87 patients[J].Minim Invasive Neurosurg,2007,50(4):219-226.

相似文献/References:

[1]徐帮杰,杨楠,白伟杰,等.坐位定点旋转整复法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2015,27(11):17.
 XU Bangjie,YANG Nan,BAI Weijie,et al.Observation on the curative effect of fixed-point rotational reduction in sitting position in the treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):17.
[2]白春晓,贾育松,孙旗,等.中医药在腰椎间盘突出症围手术期应用的研究进展[J].中医正骨,2015,27(11):65.
[3]王少纯,周英杰.郭维淮教授运用活血益气通经汤治疗腰椎间盘突出症的经验[J].中医正骨,2015,27(11):75.
[4]苏洪,张雪林.患侧下肢牵引配合腰椎斜扳法治疗 极外侧型腰椎间盘突出症[J].中医正骨,2015,27(10):40.
[5]谢冬群,黄中梁,叶金丽.加强隔附子饼灸治疗肾阳虚型腰椎间盘突出症的 临床研究[J].中医正骨,2015,27(09):18.
 XIE Dongqun,HUANG Zhongliang,YE Jinli.Clinical study on intensive aconite root cake separated moxibustion in the treatment of kidney-yang-deficiency-type lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):18.
[6]沈海良,钱万锋,周骁栋.针刀松解联合局部封闭与口服中药治疗腰椎间盘突出症[J].中医正骨,2015,27(09):46.
[7]王仁灿,黄炎洪,潘伟江,等.45°肩踝悬吊牵引下撞击腰椎疗法治疗L5S1椎间盘突出症[J].中医正骨,2015,27(08):51.
[8]任博文,杨豪.口服桂葛萆薢汤加减配合功能锻炼治疗 寒湿型腰椎间盘突出症[J].中医正骨,2015,27(08):53.
[9]阮朝阳,曾强华,朱群威.口服消栓口服液和甲钴胺胶囊治疗腰椎间盘突出症 经皮椎间孔镜术后下肢残留神经症状[J].中医正骨,2015,27(12):71.
[10]丁晓医,周子静.射频热凝联合臭氧注射治疗腰椎间盘突出症的护理[J].中医正骨,2015,27(12):81.
[11]贾传广.经皮椎间孔镜技术治疗腰椎间盘突出症[J].中医正骨,2015,27(06):49.
[12]周鑫,刘世珑,刘鹏,等.髓核摘除结合Wallis棘突间动态稳定系统 内固定治疗腰椎间盘突出症[J].中医正骨,2015,27(04):67.
[13]吕成国,杨勇,梅伟,等.后路Quadrant通道下锁孔髓核摘除术治疗单节段颈椎间盘突出症[J].中医正骨,2018,30(07):73.
[14]王飞雄,陈焕庆,邓敦.脊柱内镜下椎间盘髓核摘除术治疗钙化型腰椎间盘突出症[J].中医正骨,2019,31(06):70.
[15]常晓盼,杨勇,孙宜保,等.后路全内镜下髓核摘除术治疗侧方型颈椎间盘突出症[J].中医正骨,2019,31(07):66.
[16]康永奇,李豪,蒲君涛.经皮椎间孔镜髓核摘除术治疗极外侧型腰椎间盘突出症[J].中医正骨,2019,31(07):72.
[17]陈扬,郑杨,黄杰烽.芍药木瓜汤加减口服在腰椎间盘突出症经皮脊柱内镜椎间盘切除术后反跳性疼痛预防中的应用[J].中医正骨,2021,33(06):72.
[18]翟亚业,秦晓彬,孟祥翔,等.可视化椎间孔成形技术在经皮椎间孔入路内镜下椎间盘切除术治疗巨大型腰椎间盘突出症中的应用…[J].中医正骨,2022,34(01):22.
 ZHAI Yaye,QIN Xiaobin,MENG Xiangxiang,et al.Application of visualization foraminoplasty in percutaneous endoscopic transforaminal discectomy for treatment of giant lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(06):22.
[19]杨焕莹,王想福,赵道洲,等.口服独活寄生汤治疗经皮内窥镜下腰椎间盘切除术后残余症状的Meta分析[J].中医正骨,2022,34(07):34.
 YANG Huanying,WANG Xiangfu,ZHAO Daozhou,et al.Oral application of Duhuo Jisheng Tang(独活寄生汤)for treatment of residual symptoms following percutaneous endoscopic lumbar discectomy:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(06):34.
[20]秦晓彬,翟亚业,李含,等.合并Modic改变对经皮内镜椎间孔入路椎间盘切除术治疗腰椎间盘突出症疗效的影响[J].中医正骨,2022,34(09):17.
 QIN Xiaobin,ZHAI Yaye,LI Han,et al.Effects of Modic changes on the clinical outcomes of percutaneous endoscopic transforaminal discectomy for treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(06):17.

更新日期/Last Update: 2017-06-20