射频消融髓核成形术治疗颈椎间盘突出症初步临床报道

目的 寻求一种颈椎间肋突出症简单，安全，有效，微创的治疗方法。方法 对62例经MRI或CT检查确诊的颈椎间盘突出症采用经皮穿刺髓核成形术（Nucleoplasty)治疗，并对其疗效进行观察分析。结果 全部患者经二周至一个月短期随访，59例症状有不同程度改善，总有效率为95.2%。无一例出现脊髓，神经及大血管损伤或术后感染等并发症。结论 髓核成形术是一种先进，安全，有效的椎间盘突出微创手术，具有操作简单，安全，微创，疗效佳，恢复快，无需住院等优点，对颈椎间盘突出症患者应尽早行此手术，以控制相关疾病的发展。     

经皮低温等离子射频消融髓核成形术治疗颈椎间盘突出症初步临床报告

目的寻求一种颈椎间盘突出症简单、安全、有效、微创的治疗方法。方法对180例经MRI或CT检查确诊的颈椎间盘突出症采用经皮穿刺髓核成形术（Nucleoplasty）治疗,并对其疗效进行观察分析。结果本组全部患者经半年至一年随访,172例症状有不同程度改善,总有效率为95．5％。术中无一例出现脊髓神经及大血管损伤或术后感染等并发症。结论髓核成形术是一种先进、安全、有效的椎间盘突出微创手术．具有操作简单、安全、微创、疗效佳、恢复快、无需住院等优点。临床实践证明该治疗方法值得推广应用。     

髓核成形术治疗颈腰椎间盘突出症

目的寻求一种治疗椎间盘突出症简单、安全、有效、微创的方法。方法对80例颈腰椎间盘突出症患者行经皮穿刺，应用射频消融髓核成形术（Nucleoplasty）对突出的椎间盘进行汽化消融成形治疗，并对其疗效进行随访、观察分析。结果全部患者经3个月～2年的短期随访，80例症状有不同程度的改善，总有效率为97．5％。无一例出现脊髓、神经及大血管损伤或术后感染等并发症。结论经皮低温等离子射频消融髓核成形术治疗颈腰椎间盘突出症，具有操作简便安全、疗效好、微创的优点。     

经皮穿刺髓核成形术治疗腰椎间盘突出症初步临床报道

目的　寻求一种简单、安全、有效、微创的椎间盘突出症治疗方法。方法　对 1 6例腰椎间盘突出症采用经皮穿刺髓核成形术 (Nucleoplasty)治疗 ,并对其疗效进行观察分析。 结果　全部患者经二周至一个月短期随访 ,症状均有不同程度改善 ,疗效优良率为 93 8% ,有效率为 1 0 0 %。未发现明显并发症。结论　髓核成形术是一种先进、安全、有效的椎间盘突出微创手术 ,具有操作简单、安全、微创、疗效佳、恢复快、无需住院等优点。     

髓核成形术治疗腰椎间盘突出症的临床研究

目的 应用髓核成形术治疗腰椎间盘突出症，观察术后的临床恢复效果。方法 对38例经临床检查和MRI或CT确诊的腰椎间盘突出症采用经皮穿刺髓核成形术(nucleoplasry)治疗，并对其疗效进行观察分析。结果 全部患者经1周～6个月短期随访，所有病例症状有不同程度改善，总有效率为81．6％，无一例出现脊髓、神经及大血管损伤或术后感染等并发症。结论 髓核成形术是一种先进、安全、有效的椎间盘突出微创手术，具有操作简单、安全、微创、疗效佳、恢复快、无需住院等优点，对腰椎间盘突出症初次发作的患者手术效果好。     

红皮穿刺髓核成形术治疗腰椎间盘突出症初步临床报道

目的：寻找一种简单，安全，有效，微创的椎间盘突出症治疗方法，方法：对16例腰椎间盘突出症采用经皮穿刺髓核成形术（Nucleoplasty)治疗，并对其疗效进行观察分析，结果：全部患者经二周至一个月短期随访，症状均有不同程度改善。疗效优良率为93．8％，有效率为100％，未发现明显并发症，结论：髓核成形术是一种先进，安全，有效的椎间盘突出微创手术，具有操作简单，安全，微创，疗效佳，恢复快，无需住院等优点。     

经皮等离子刀在颈椎间盘突出症的应用

目的探讨等离子刀微创治疗颈椎间盘突出症的疗效。方法对82例颈椎间盘突出症实施经皮等离子髓核成形术,术前、术后利用VAS评分评价患者颈肩痛的程度,结合患者满意度及Williams疗效标准评价疗效。结果全部病例术后均随访1年以上,术后1、3、6、12个月VAS评分与术前比较明显下降,有显著差异(P<0.01),患者满意度高,临床疗效好。结论适当选择病例,经皮等离子髓核成形术是一种微创、操作简单、安全、有效的颈椎间盘突出症的治疗手段。     

经皮低温等离子髓核成形术治疗椎间盘突出症

目的探讨经皮低温等离子髓核成形术治疗椎间盘突出症的临床疗效。方法39例具有临床症状的颈椎间盘突出症和19例具有临床症状的腰椎间盘突出症的患者,经皮低温等离子髓核成形术治疗,各项观测指标包括患者症状的缓解率,采用改良的Macnab法分析腰椎术后疗效,手术中失血量,患者平均住院时间及并发症等。结果本组随访时间1～6个月,平均3．4个月,总的症状缓解率90．2％,Macnab法分析腰椎术后疗效优良率为79％,患者平均住院时间3d,无并发症的发生。结论低温等离子髓核成形术治疗椎间盘突出症的满意率高,住院治疗时间短,创伤小,不影响再次手术治疗。是一种安全、有效的治疗椎间盘突出症的微创治疗新方法。对颈椎或腰椎间盘突出症的患者应尽早行此手术,以控制相关疾病的发展。     

双极射频髓核成形术治疗腰椎间盘突出症

目的 探讨双极射频椎间盘髓核成形术治疗腰椎间盘突出症的临床疗效及安全性.方法 腰椎间盘突出症患者167例,192个椎间盘在CT引导下行射频椎间盘髓核成形术,其中单极射频治疗71例,双极射频治疗96例.在术后7、30、90、180 d随访患者的疗效及并发症.结果 按改良的Macnab疗效评定标准,双极组治疗后180 d的优良率及有效率明显高于单极组(P＜0.05),两组均未发生严重并发症.结论 双极射频椎间盘髓核成形术是一种安全、有效的治疗椎间盘突出的微创手术方法.     

双极射频髓核成形术联合臭氧减压术治疗腰椎间盘突出症的临床应用

目的探讨双极射频椎间盘髓核成形术联合臭氧减压术治疗腰椎间盘突出症的临床疗效及安全性。方法选择2013年1～12月腰椎间盘突出症患者95例,随机分为双极组(n=47)和联合组(n=48),分别在CT引导下行双极射频椎间盘髓核成形术、双极射频椎间盘髓核成形术联合臭氧减压术。观察两组患者术后7、30、90、180d的疗效以及是否出现椎间盘感染、神经损伤等并发症。结果按改良的Macnab疗效评定标准,联合组在治疗后各时点的优良率及有效率均明显高于射频组(P0.05)。结论双极射频椎间盘髓核成形术联合臭氧减压术是一种安全、有效的治疗椎间盘突出症的微创手术方法。     

射频消融髓核成形术治疗腰椎间盘突出症

目的：探讨射频消融髓核成形术治疗腰椎间盘突出症的手术技巧、疗效和适应证。方法：对86例腰椎间盘突出症患者采用经皮穿刺射频消融髓核成形术(nucleoplasty)治疗，并对其疗效进行观察分析。结果：86例患者经3～18个月随访，根据“中华医学会骨科分会脊柱学组腰背痛手术评定标准”，术后疗效优10例，良65例，可6例，差3例，优良率87．2％，有效率为96．5％。无相关并发症发生。结论：射频消融髓核成形术操作简单、安全，是治疗腰椎问盘突出症的有效微创手术。     

经皮等离子消融髓核成形术治疗腰椎间盘突出症: 28例随访报告

目的 探讨腰椎间盘突出症的治疗方法。方法经体格检查，CT和／或MRI检查确诊的腰椎间盘突出症患者28例，采用等离子消融髓核成形术治疗，以Prolo功能和经济结果评定法和VAS评分评定疗效。结果髓核成形组总体治疗成功率82．1％；平均住院时间7．6天，复发率10．8％。并发椎间盘炎1例，进行腰椎融合术后治愈。结论髓核成形术治疗腰椎间盘突出症的满意率较高，复发率低，住院治疗时间短，创伤小，不影响再次手术治疗。髓核成形术是一种安全、有效的治疗腰椎间盘突出症的微创介入治疗新方法。     

颈椎间盘突出症微创介入治疗进展

背景 颈椎间盘突出症是在颈椎间盘退变的基础上,因轻微外力或无明确诱因导致椎间盘突出而致脊髓和神经根受压产生相应症状的临床症候群.随着生活节奏的加快,患者人数不断增加.目前对颈椎间盘突出症的治疗方法较多,基本分为保守治疗、手术治疗及微创介入治疗3大类.目的 阐述介入治疗的创伤小、能同时治疗多个节段和并发症少等优点.内容 ...     

等离子刀联合髓核化学溶解术（胶原酶）治疗腰椎间盘突出症的近期疗效观察

目的探讨应用等离子刀融切术联合髓核化学溶解术（胶原酶）治疗腰椎间盘突出症（lumbar intervertebral disc protrusion,LIDP）的效果。方法2002年1月～2007年1月,对80例LIDP应用等离子刀手术系统对突出的腰椎间盘进行汽化消融成形,然后注入溶于5ml无菌生理盐水的国产胶原酶1200U溶解椎间盘内的髓核组织。结果80例术后2周、4周、6个月获得随访,按改良的MacNab疗效评估标准,优62例,良10例,可6例,差2例。优良率90%（72/80）。无严重并发症发生。结论应用等离子刀联合髓核胶原酶溶解手术是一种行之有效的微创治疗方法,但其适应证应严格掌握。     

低温等离子消融髓核成形术与保守疗法治疗腰椎间盘突出症的对比研究

目的：比较低温等离子消融髓核成形术与保守疗法治疗包容性腰椎间盘突出症的疗效。方法：69例经体格检查、CT和，或MRI检查确诊的包容性腰椎间盘突出症患者随机分为两组，髓核成形术治疗组28例，采用低温等离子消融髓核成形术治疗；保守治疗组41例，采用卧床休息、抗炎、理疗等综合保守疗法。随访1年～2年8个月，平均2．1年，采用Prolo功能评定法和VAS评分评定疗效。结果：髓核成形术治疗组和保守治疗组总体治疗成功率分别为82．1％和85.4％，差异无显著性（P〉0．05）；两组平均住院时间分别为7．6d和16．9d，差异有显著性（P〈0．05）：复发率分别为10．8％和22％，差异有显著性（P〈0．05）。髓核成形术治疗组并发椎间盘炎1例，行腰椎融合术后治愈。结论：髓核成形术和保守疗法治疗包容性腰椎间盘突出症的满意率相近，但髓核成形术治疗组复发率低，住院治疗时间短，是一种安全、有效的治疗包容性腰椎间盘突出症的微刨治疗方法。     

Treatment of cervical disc herniation through percutaneous minimally invasive techniques

Purpose

The goal of this study is to compare the therapeutic effectiveness of percutaneous cervical discectomy, percutaneous cervical disc nucleoplasty, and a combination of the two for the treatment of cervical disc herniation and the effective stabilization of the cervical vertebral column.

Methods

A retrospective study was performed from February 2003 to April 2011. One hundred and seventy-one cervical disc herniation patients with a mean age of 47.8 years (ranging from 21 to 74 years) participated in the study and were treated with the three types of percutaneous minimally invasive techniques: percutaneous cervical discectomy (PCD, 97 cases), percutaneous cervical disc nucleoplasty (PCN, 50 cases), and a combination of the two (PCDN, 24 cases). After treatment, the postoperative clinical results and the stability of the cervical vertebral columns of these three groups were evaluated and compared.

Results

Patients in the PCD group received follow-up care for approximately 4.1 years (ranging from 0.2 to 8.5 years), while those in the PCN group received only an average of 2.6 years (ranging from 0.3 to 7.8 years), and the PCDN group received an average of 3.3 years (ranging from 0.2 to 8 years of follow-up). According to the Japanese Orthopedic Association scoring system, the functional scores (JOA scores) differed significantly between the pre- and postoperative patients within the three groups (PCD t = 21.849, P = <0.05; PCN t = 14.503, P < 0.05; PCDN t = 8.555, P < 0.05). All patients had been successfully operated on by the same spinal surgeon team. According to the Odom criterion, the clinical outcomes were not significantly different for any of the three groups (the recovery rate using the JOA standard evaluation, F = 2.19, P = 0.116, P > 0.05). The percentages of each procedure that received either an excellent or a good rating were PCD at 81.35 %, PCN at 82.44 % and PCDN at 83.19 %. In addition, the clinical success rates among the three were not significantly different (P > 0.05). Notably, there was no postoperative instability of the cervical vertebral column in any of the patients (P > 0.05), and there was no difference in the pre- or postoperative stability of the cervical vertebral columns in each group.

Conclusions

Each group achieved good clinical outcomes with this safe, minimally invasive spinal surgery for the treatment of cervical disc herniation. In addition, no postoperative risk of cervical instability was found.     

Anterior minimally invasive approaches for the cervical spine

The percutaneous endoscopic discectomy (PECD) with working channel endoscope (WSH) endoscopy set could be a safe and effective minimally invasive surgical option for non-contained cervical disc herniation in selected patients. Judicious use of the end-firing Ho: Yttrium-Aluminium-Garnet (YAG) laser for both decompressive and thermoannuloplasty effect during the percutaneous endoscopic cervical annuloplasty (PECA) is mandatory in order to prevent possible injury to spinal cord or root. Although the percutaneous cervical stabilization (PCS) using the cervical B-Twin may not completely replace the cervical arthrodesis, this minimally invasive procedure can preserve anterior structures and thereby retain segmental stability and prevent the possible kyphotic progression after fusion surgery. To our knowledge, these minimally invasive procedures for cervical spine disease may serve to minimize surgery-induced complications associated with anterior cervical discectomy and fusion (ACDF).