经皮后路全内镜下锁孔术与颈前路椎间盘切除融合术治疗神经根型颈椎病的短期疗效

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Abstract

Objective To compare and analyze the short-term efficacy of percutaneous posterior full-endoscopic key-hole surgery and anterior cervical discectomy and fusion(ACDF) in the treatment of cervical radiculopathy(CR)，and to explore the choice of treatment scheme for CR.Methods A retrospective analysis was conducted on the data of 52 CR patients who underwent surgical treatment at Beijing Electric Power Hospital from April 2019 to April 2021.In endoscopic group，25 patients underwent percutaneous posterior full-endoscopic key-hole surgery.This group included 14 males and 11 females，with an average age of (46.61±9.23) years.In fusion group，27 cases were treated with ACDF.This group included 14 males and 13 females，with an average age of (52.32±9.05) years.Visual analog scale Japanese orthopaedic association(JOA)，neck disability index(NDI) evaluations，physiological curvature measurement of the cervical spine at the last follow-up and modified MacNab efficacy evaluation were used to evaluate the surgical efficacy.Results Both groups of patients successfully completed the surgery，with a surgical time of (73.23±7.61) min in the endoscopic group and (75.28±8.49) min in the fusion group.The hospitalization time and recovery time of the endoscopic group were shorter than those of the fusion group.At 3 days，3 months，6 months，and 12 months after surgery，the neck VAS scores in the endoscopic group and fusion group were significantly lower than those before surgery (P＜0.001).At 3 days after surgery，the neck VAS scores in the endoscopic group were significantly lower than those in the fusion group (P＜0.05).There was no statistically significant difference in the neck VAS scores between the two groups at 3，6 and 12 months after surgery (P＞0.05).The NDI scores at 3 days，3 months，6 months and 12 months after surgery in both groups were significantly lower than those before surgery (P＜0.001).There was no statistically significant difference in NDI scores between the two groups (P＞0.05).At 3，6 and 12 months after surgery，the JOA scores of the two groups increased compared to those before surgery (P＜0.05).There was no statistically significant difference in JOA scores between the two groups (P＞0.05).The evaluation results of the improved MacNab efficacy in the endoscopic group were excellent in 15 cases，good in 7 cases，fair in 2 cases，and poor in 1 case，with an excellent and good rate of 88.00%.The evaluation results of the improved MacNab in the fusion group were excellent in 17 cases，good in 8 cases，and fair in 2 cases，with an excellent and good rate of 92.59%.Conclusion Percutaneous posterior endoscopic key-hole surgery and traditional ACDF can both achieve good results in the treatment of CR.Both methods can be selected.The elderly patients who cannot tolerate general anesthesia are more recommended to consider percutaneous posterior endoscopic spinal surgery.

Key words： cervical radiculopathy anterior cervical discectomy and fusion percutaneous posterior full-endoscopic key-hole surgery

Corresponding Authors: Du Mingkui

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	Zhang Liming
	Du Mingkui
	Zhang Xifeng
	Zhong Weitao

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Zhang Liming,Du Mingkui,Zhang Xifeng, et al. Short Term Efficacy of Percutaneous Posterior All Endoscopic Keyhole Surgery and ACDF for Cervical Radiculopathy[J]. sygkzz, 2023, 29(4): 289-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I4/289

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