全内镜下椎板开窗术治疗单节段脊髓型颈椎病的临床疗效

Clinical observation on the treatment of single segment cervical spondylotic myelopathy by full endoscopic lamina fenestration discectomy surgery

摘要:

目的 观察全内镜下椎板开窗术（Endo-LOVE）治疗单节段脊髓型颈椎病（CSM）的临床疗效。方法 回顾性分析2021年1月-2021年12月接受Endo-LOVE的26例单节段CSM患者的临床资料。观察术前、术后3 d、术后6个月和术后1年随访时的颈椎功能障碍指数（NDI）和日本骨科学会（JOA）评分；术后1年，根据脊髓功能改善率评价临床疗效，并行颈椎动力位X线检查，评价手术节段的稳定性。结果 26例患者手术均顺利完成，无严重并发症发生，术后症状均明显改善；术后均随访12～18个月，术后各时间点JOA评分和NDI与术前比较，差异均有统计学意义（P < 0.05），术后1年行颈椎动力位X线检查，未见手术节段失稳病例，术后1年评价疗效，优16例，良7例，可3例，优良率为88.46%。结论 Endo-LOVE治疗单节段CSM安全、有效、微创，短期随访疗效满意，具有一定的临床实用价值。

Abstract:

Objective To observe the clinical effect of full endoscopic lamina fenestration discectomy (Endo-LOVE) surgery in the treatment of single segment cervical spondylotic myelopathy.Methods The retrospective study was conducted on 26 cases with single segment cervical spondylotic myelopathy treated by Endo-LOVE surgery. Neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were used to evaluate the clinical effect at preoperative, postoperative 3 days, postoperative 6 months, and 1-year follow-up. The stability of surgical segment were observed by X-ray examination 1 year postoperative.Results 26 cases of Endo-LOVE surgery were all smoothly accomplished. The clinical symptoms of all these cases were improved; 26 cases were followed up from 12~18 months. There were significant differences between preoperative and postoperative on JOA score and NDI (P < 0.05). One year after surgery, cervical dynamic X-ray examination was performed, and no cases of surgical segment instability were found. The efficacy was evaluated one year after surgery, with 16 cases excellent, 7 cases good, and 3 cases fair, with an excellent and good rate of 88.46%.Conclusion Endo-LOVE surgery is safe, effective and minimally invasive in the treatment of single segment cervical spondylotic myelopathy.