脊髓型颈椎病内镜下前路椎间盘切除融合术
Endoscopic anterior discectomy and fusion for cervical spondylotic myelopathy
钟绵森 1钟远鸣 2黄保华 2唐福波 2胡江 1许伟 2曾平1
作者信息
- 1. 广西中医药大学,广西南宁 530023
- 2. 广西中医药大学第一附属医院,广西南宁 530023
- 折叠
摘要
[目的]介绍内镜辅助下前路颈椎间盘切除融合术(endoscopic anterior cervical discectomy and fusion,E-ACDF)的手术技术和初步临床结果.[方法]2021年1月-2023年2月,对15例脊髓型颈椎病患者行E-ACDF术.内镜下切除突入椎管内的椎间盘组织、椎体骨赘、后纵韧带,确定硬膜前方完全减压无压迫,硬膜搏动恢复,用撑开器械将椎间隙撑开,将融合器置入椎间隙,将颈椎前路钉板放置融合节段正前方并固定钢板.[结果]所有患者顺利完成手术,术中无严重并发症,均获随访6～12个月.与术前相比,末次随访时 VAS评分[(4.7±0.2),(2.2±0.1),P＜0.001]、ND1评分[(31.7±1.4),(11.3±0.7),P＜0.001]、JOA评分[(5.1±0.2),(11.5±0.3),P＜0.001]均显著改善.术后复查颈椎影像,颈椎内固定及椎间盘术后在位,硬脊膜及神经根减压彻底.[结论]E-ACDF治疗脊髓型颈椎病,具有清晰的可视化手术视野,是一种精准、安全可靠且能够实现充分减压的手术方式,短期疗效满意.
Abstract
[Objective]To present the surgical techniques and preliminary clinical results of endoscopic anterior cervical discectomy and fusion(E-ACDF).[Methods]E-ACDF was performed on 15 patients with cervical spondylotic myelopathy from January 2021 to Febru-ary 2023.The intervertebral disc tissue,osteophyte on the vertebral body,and posterior longitudinal ligament protruding into the spinal ca-nal were removed under endoscope,and the anterior dural space was confirmed to be completely decompressed without compression,and the dural beating was restored.As the intervertebral space was extended with a distractor,a fusion cage was implanted into the space,and then anterior cervical plate was placed directly in front of the fusion segment,and was fixed with screws.[Results]All patients were successfully operated without serious complications,and followed up for 6 to 12 months.Compared with those preoperatively,VAS score[(4.7±0.2),(2.2± 0.1),P＜0.001],NDI score[(31.7±1.4),(11.3±0.7),P＜0.001],JOA score[(5.1±0.2),(11.5±0.3),P＜0.001]significantly improved at the latest follow up.Postoperative cervical images revealed internal fixation implants in proper position,with completely decompressed dura and nerve roots.[Conclusion]E-ACDF takes advantage of clear visual surgical field for the treatment of cervical spondylotic myelopathy.It is an ac-curate,safe and reliable surgical method for full decompression,and achieve satisfactory outcome in short-term.
关键词
脊髓型颈椎病/脊柱内镜/前路颈椎间盘切除融合术Key words
cervical spondylotic myelopathy/spinal endoscopy/anterior cervical discectomy and fusion引用本文复制引用
基金项目
国家自然科学基金项目(81760874)
国家自然科学基金项目(82260942)
广西重点研发计划项目(桂科AB20159018)
广西青年基金课题项目(Z20200484)
广西青年基金课题项目(GXZYA20220025)
2019年研究生教育创新计划项目(JGY2019108)
出版年
2024
NETL
NSTL
万方数据