颈椎单开门椎板成形术是否椎间孔切开的比较

[目的]比较单开门椎板成形术中采用与不采用椎间孔切开的临床结果.[方法] 2015年1月～2019年6月,对68例混合型颈椎病患者行后路单开门椎板成形术,其中,早期的38例行单纯单开门成形术(非切开组),后期的30例行单开门成形联合椎间孔切开术(切开组).比较两组患者围手术期、随访与影像资料.[结果]两组患者均顺利手术...     

前路椎间盘切除及椎间孔切开术治疗脊髓神经根型颈椎病

2002年3月-2004年7月，我们采用前路椎间盘切除及椎间孔切开术治疗脊髓神经根型颈椎病13例，效果满意，报告如下。     

关于《单开门椎管成形联合椎间孔切开治疗神经根型颈椎病》一文题目的说明

刊登于我刊2012年第18卷第2期第105页的《单开门椎管成形联合椎间孔切开治疗神经根型颈椎病》一文,第一作者为孙天威,题目应为《单开门椎板成形术联合椎间孔切开术治疗脊髓型合并神经根型颈椎病疗效分析》,特此说明。     

颈椎后路单开门联合椎间孔切开术治疗颈椎后纵韧带骨化的疗效分析

目的 :探讨颈椎后路单开门联合椎间孔切开术在治疗颈椎后纵韧带骨化中临床疗效。方法 :对2011年9月至2015年9月收治的45例颈椎后纵韧带骨化症患者进行回顾性研究,其中男26例,女19例;年龄28~71岁,平均53.6岁;24例采用后路单开门椎管扩大成形联合椎间孔切开术治疗(联合椎间孔切开组),21例采用单纯后路单开门椎管扩大成形术治疗(单纯单开门组)。比较两组患者的手术时间、术中出血、C_5神经麻痹及轴性症状发生情况;观察两组患者手术前后的JOA评分并计算神经功能改善率;分析两组患者的NDI评分及颈椎Cobb角的变化。结果:两组患者术后均获得随访,时间12~24个月,其中联合椎间孔切开组平均随访时间为(14.3±2.8)个月,单纯单开门组为(13.7±3.1)个月,两组比较差异无统计学意义(P0.05)。两组患者在手术时间、术中出血方面差异均无统计学意义(P0.05)。两组患者术后JOA评分较术前均明显提高(P0.05),但两组改善率比较差异无统计学意义(P0.05)。末次随访时联合椎间孔切开组和单纯单开门组的NDI评分分别为13.6±1.8和16.1±2.4,两组比较差异有统计学意义(P0.05);C_5神经麻痹发生率分别为4.2%(1/24),28.6%(6/21),两组差异有统计学意义(P0.05);轴性症状发生率分别为8.3%(2/24),9.5%(2/21),两组差异无统计学意义(P0.05)。末次随访时两组患者的颈椎Cobb角与术前比较差异无统计学意义(P0.05),组间比较差异也无统计学意义(P0.05)。结论:颈椎后路单开门扩大椎管成形联合椎间孔切开术不仅能够充分的解除脊髓压迫,亦可扩大椎间孔,松解受压神经根,缓解根性症状,同时在预防C_5神经根麻痹等并发症的出现亦取得了良好的效果,是一种治疗伴有神经根症状的颈椎后纵韧带骨化症有效方法。     

改良的单开门椎板成形术治疗脊髓型颈椎病

目的介绍一种改良的单开门椎板成形术并观察其疗效和对颈椎稳定性的影响。方法对19例颈椎病患者进行改良的单开门手术,手术前和随访时进行JOA评分并了解颈肩痛的发生率和持续时间,CT／MRI测量椎管的矢状径,动力位摄片观察颈椎的稳定性,测量C2-C7 Cobb角观察颈椎前凸的变化。结果平均随访时间为13个月,JOA评分自术前平均为8．76提高到随访时12．12分,改善率平均为45．4％;颈肩痛发生率26.3％;各节段椎管矢状径均有明显增大,而最大的增幅出现在C5水平;颈椎前凸并没有发生明显改变;随访时的动力位摄片没有发现颈椎节段性不稳定。结论这种应用羟基磷灰石spacer并进行后方韧带重建的改良的单开门手术治疗脊髓性颈椎病效果良好,由于保留了后方的棘突和韧带并进行了重建,术后颈椎的生理弧度和稳定性良好。     

后路单开门联合椎间孔切开术与前路减压融合术治疗混合型颈椎病的疗效比较

 目的 通过回顾性病例分析,评价单开门椎板成形联合椎间孔切开术(laminoplasty with foraminotomy, LF )与前路椎间盘切除减压融合术（anterior cervical discectomy and fusion,ACDF）治疗脊髓神经根型颈椎病的临床及影像学疗效。方法 自 2008 年 1 月至 2010 年 1 月,按照纳入及排除标准选取 68 例患者纳入研究,ACDF 组 33 例,LF 组 35 例,随访均超过 2 年。疗效评估采用日本骨科协会（Japanese Orthopedic Association,JOA）评分及改善率,影像学评估采用 X 线片测量颈椎曲度和颈椎活动度（range of motion, ROM）,末次随访时采用颈椎功能障碍指数量表（neck disabilitv index,NDI）评估两组患者颈肩部疼痛的改善程度。结果 ACDF 组手术时间平均 187 min、出血量平均为 127 ml,与 LF 组（154 min、235 ml）比较,差异均有统计学意义（t _手术时间=4.170,P=0.000;Z _出血量=-6.888,P=0.000）。术后两组下肢感觉改善率（ACDF 组 64.0%、 LF 组 66.0%）的差异有统计学意义（Z=-7.512,P=0.000）,而上肢运动、上肢感觉及下肢运动改善率的差异均无统计学意义。术后 3 个月时 ACDF 组出现 1 例植骨不融合,随访 2 年时 3 例出现邻近节段退变;而 LF 组未见并发症出现。末次随访时 ACDF 组在提物（Z=-3.947, P=0.000）及开车（t=-7.523,P=0.000）方面的 NDI 疼痛评分低于 LF 组。ACDF 组颈椎曲度由术前平均 13.7°增加至 16.2°,而 LF 组由 14.6°降至 13.3°（Z=-3.374,P=0.001）。两种术式均导致术后颈椎 ROM 下降（ACDF 组 14.8°、LF 组 16.5°）,但差异有统计学意义（t=-2.167,P =0.034）。结论 LF 在改善长节段颈椎间盘突出所致的颈椎髓性症状及根性症状方面与 ACDF 的临床效果相近,但具有手术时间短、手术技术相对简单、近期并发症发生率低等优势,是治疗混合型颈椎病安全、有效的手术方式。     

单开门椎管扩大成形术治疗脊髓型颈椎病疗效分析

目的　评价后路单开门椎管扩大成形术治疗脊髓型颈椎病的疗效及影响因素。方法　对 4 7例脊髓型颈椎病行单开门椎管成型术 ,平均随访时间 39 2个月 ,手术前后应用JOA评分法 ,对脊髓功能的改善情况进行对比分析。结果　病程小于 6个月者 2、 3年改善率分别为 6 8 0 6 %、 6 9 2 1 % ;病程超过 6个月者 2、 3年改善率分别为 6 1 80 %、 6 2 4 3%。术后 2年的改善率与术前JOA评分呈负相关性 (r=- 0 30 )。结论　单开门椎管扩大成形术后疗效肯定 ,术后缓解率同病程长短以及术前脊髓功能受损程度有关 ,脊髓功能恢复在 2年时基本稳定     

微创前路经上位椎体椎间孔减压术治疗神经根型颈椎病

【摘要】 目的：探讨微创前路经上位椎体椎间孔减压术治疗神经根型颈椎病的有效性。方法：2008年7月~2010年7月12例单侧神经根型颈椎病患者在延边大学医院接受微创前路经上位椎体椎间孔减压术。其中男7例,女5例,年龄为35~68岁,平均49岁。椎间孔狭窄部位：C5/6 4例,C6/7 5例,C7/T1 3例。软性髓核突出3例,钩椎关节骨质增生7例,突出的髓核钙化2例。均行前路手术,术中采用脊柱手术专用显微镜,在病变上位椎体确定钻孔起始部位,利用高速钻石气钻磨出一约6mm直径的通路达到病变区域,减压椎间孔。观察术前及末次随访时上肢放射性疼痛的VAS评分、颈椎功能障碍指数（NDI）及病变水平椎间盘高度。结果：手术时间为56~110min,平均86±6min;术中失血量为40~120ml,平均92±8ml。无椎动脉损伤、贺纳氏综合征、喉返神经损伤等并发症。术后随访时间为12~23个月,平均15.8±1.3个月。术前上肢疼痛VAS评分为8.5±0.5分（7~10分）,末次随访时为1.4±0.2分（0~3分）,两者比较有显著性差异（P<0.05）;术前NDI为26.4±1.3分（22~31分）,末次随访时为4.2±0.6分（3~8分）,两者比较有显著性差异（P<0.05）,改善率为84.1%;术前病变水平椎间盘高度为5.4±0.7mm（4.2~6.1mm）,末次随访时为4.9±0.7mm（3.6~5.8mm）,两者比较无显著性差异（P>0.05）。术后满意度为100%。结论：微创前路经上位椎体椎间孔减压术可减少对椎间盘的损伤,是治疗单侧神经根型颈椎病的有效手术方法。     

神经根型颈椎病椎间孔内神经根受压的原因分析及减压方式选择

目的:分析神经根型颈椎病患者椎间孔内神经根受压的原因,选择合理的减压方式。方法 :2010年1月~2013年8月,我院共收治神经根型颈椎病患者178例,其中56例为椎间孔内神经根受压所致的单侧神经根型颈椎病,术前VAS评分为8.99±1.01分(7~10分);颈椎功能障碍指数(NDI)为41.15±7.12分(37~49分)。根据术前影像学资料判断椎间孔内神经根受压的原因分为3组:单纯椎间盘压迫,14例(A组);单纯骨性压迫,22例(B组);混合压迫(椎间盘+骨性压迫),20例(C组)。A组切除椎间盘至钩椎关节,适当扩大椎间孔,取出突出髓核;B、C组切除椎间盘至钩椎关节后,将钩突基底部内侧磨平,充分显露钩突后部、上位椎体后下角及钩椎关节间隙,刮除上位椎体后下角及部分增生的钩突。减压后均行椎间植骨内固定。使用Surgimap软件测量患者术前颈椎双斜位X线片上病变节段的双侧椎间孔面积,将健侧与患侧的椎间孔面积进行对比。比较3组患者术前及末次随访时VAS评分和NDI,同时比较3组的手术时间、术中出血量和术后住院时间。结果:3组患者术前健侧椎间孔面积无显著性差异(P0.05),B组和C组的患侧椎间孔面积均较A组明显狭窄(P0.05);B组和C组无显著性差异(P0.05);B组和C组的患侧椎间孔面积均较各自的对侧椎间孔面积明显狭窄(P0.05);而A组患侧椎间孔面积较对侧无明显狭窄(P0.05)。3组患者均顺利完成手术,B、C组与A组相比术中出血量较多,手术时间和术后住院天数较长(P0.05);B组与C组比较无显著性差异(P0.05)。术后3组患者均无神经症状加重、感染及脑脊液漏等并发症发生。56例患者均获得随访,随访时间27.2±8.9个月(12~52个月),3组术前VAS评分和NDI比较无显著性差异(P0.05),末次随访时亦无显著性差异(P0.05);3组末次随访时与术前比较均有显著性差异(P0.05)。结论:术前根据影像学资料分析神经根型颈椎病患者椎间孔内神经根受压的原因,进行针对性的减压手术可取得良好效果。     

单开门椎板成型术治疗老年脊髓型颈椎病

[目的]探讨老年脊髓型颈椎病的主要病理机制并对单开门椎板成型术在治疗老年脊髓型颈椎病中疗效予以评价。[方法]2000年3月~2008年3月,40例年龄在70岁以上的老年脊髓型颈椎病患者,平均75.4岁(70~85岁)于本科行单开门椎板成型术。在此同一时期内选择40例年龄在60岁以下脊髓型颈椎病患者作为对照组,平均51.2岁(33~60岁)。所有患者至少随访3年,平均6.7年(3~10年)。分别对手术前后JOA评分、改善率、影像学表现及术后并发症进行统计分析。[结果]两组患者术后JOA评分均有显著改善,老年组术后2年效果最佳,术后5年改善率略低与对照组,但无统计学差异。老年组术前颈椎动力位X线片示颈椎不稳发生率明显高于对照组。[结论]单开门椎板成形术可以达到解除神经压迫,维持颈椎稳定性的目的,并在治疗老年脊髓型颈椎病中有良好的疗效。     

Percutaneous Full-Endoscopic versus Biportal Endoscopic Posterior Cervical Foraminotomy for Unilateral Cervical Foraminal Disc Disease

BackgroundThe biportal endoscopic technique (BE) is a fast-growing surgical modality that can be applied to posterior cervical foraminotomy (PCF), as well as lumbar discectomy and decompressive laminectomy. It has several technical differences from the percutaneous full-endoscopic technique (PE), which has been standardized as the representative endoscopic spinal surgery technique. The purpose of this study was to compare the short-term clinical outcomes between BE-PCF and PE-PCF.MethodsA retrospective review was conducted on 66 patients who had single-level unilateral cervical foraminal disc disease (UCFD). All patients underwent PE- or BE-PCF. Clinical outcomes including visual analog scale (VAS)-arm, VAS-neck, and Neck Disability Index (NDI) were evaluated. Perioperative data including operation time, length of hospital stay (LOS), amount of surgical drain, postoperative complications, and reoperation were collected. Serum creatine phosphokinase (CPK) and C-reactive protein (CRP) levels were recorded.ResultsA total of 65 patients were included in the final analysis: 32 with PE-PCF and 33 with BE-PCF. There was no statistically significant difference in demographic and preoperative data between the two groups. All patients had significant improvement in VAS-arm, VAS-neck, and NDI compared to the baseline value. The improvement of all parameters was comparable between the two groups at each point for 1 year after surgery (p > 0.05), except for the significantly lower VAS-neck at postoperative 2 days in PE-PCF (p = 0.005). The total operation time was significantly shorter in BE-PCF (p = 0.036). There were no statistically significant differences between the two groups in regard to LOS, amount of surgical drain, and serum CPK and CRP levels (p > 0.05). Reoperation and complications between the two groups were comparable (p > 0.05).ConclusionsThe 1-year postoperative clinical outcomes of PE-PCF and BE-PCF for cervical pain and disability caused by UCFD were good and comparable. PE-PCF resulted in significantly less immediate postoperative neck pain, but BE-PCF required shorter total operation time.     

Comparison of Anterior Cervical Discectomy and Fusion versus Posterior Cervical Foraminotomy in the Treatment of Cervical Radiculopathy: A Systematic Review

Controversy remains over whether anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF) is superior for the treatment of cervical radiculopathy. We therefore performed a systematic review including three prospective randomized controlled trails (RCT) and seven retrospective comparative studies (RCoS) by searching PubMed and EMBASE. These studies were assessed on risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and level of recommendation were evaluated according to the GRADE approach. Clinical outcomes, complications, reoperation rates, radiological parameters, and cost/cost‐utility were evaluated. The mean complication rate was 7% in the ACDF group and 4% in the PCF group, and the mean reoperation rate was 4% in the ACDF group and 6% in the PCF group within 2 years of the initial surgery. There was a strong level of recommendation that no difference existed in clinical outcome, complication rate and reoperation rate between the ACDF and the PCF group. There was conflicting evidence that the ACDF group had better clinical outcomes than the PCF group (one study with weak level of recommendation). PCF could preserve the range of motion (ROM) of the operated segment but did not increase the ROM of the adjacent segment (weak level of recommendation). Meanwhile, the average cost or cost‐utility of the PCF group was significantly lower than that of the ACDF group (weak level of recommendation). In conclusion, the PCF was just as safe and effective as the ACDF in the treatment of cervical radiculopathy. Meanwhile, PCF might have lower medical cost than ACDF and decrease the incidence of adjacent segment disease. Based on the available evidence, PCF appears to be another good surgical approach in the treatment of cervical radiculopathy.     

经前路椎间孔减压植骨固定治疗神经根型颈椎病

目的探讨经前路颈椎间孔减压植骨融合内固定术治疗神经根型颈椎病的疗效。方法回顾分析我院自2005年1月至2008年12月对21例神经根型颈椎病患者采用的经前路颈椎间孔减压植骨融合内固定术治疗。采用日本骨科学会（Japanese orthopaedics association,JOA）及视觉模拟评分（visual analogous scale,VAS）评分,观察术前、术后即刻、6个月、18个月疗效。结果共治疗观察21例患者,采用JOA评分,术前评分（8.50±1.25）分,随访终末评分（13.70±1.33）分,手术前后JOA评分具有显著性差异（P〈0.05）。VAS评分：术前评分（6.85±1.18）分,随访终末评分（2.15±1.30）分,手术前后VAS评分具有显著性差异（P〈0.05）。术后12个月植骨融合率为100%;术前Cobb角为10.3°（-5°～16°）,随访终末Cobb角为15.5°（0°～20.5°）;术后均无感染、喉返神经、喉上神经及椎动脉损伤,切口均一期愈合;无翻修手术者。结论经前路颈椎间孔减压植骨融合内固定术治疗神经根型颈椎病具有创伤小、减压直接、疗效确切的优点。     

后路颈椎经皮全内镜下髓核摘除术联合小针刀技术治疗神经根型颈椎病的近期疗效观察

目的:观察后路颈椎经皮全内镜下髓核摘除术联合小针刀技术治疗神经根型颈椎病的短期疗效。方法:选取北京市隆福医院骨科2017年8月—2018年8月收治的80例神经根型颈椎病患者,随机分为手术组和联合组,每组均40例,手术组运用后路颈椎经皮全内镜下髓核摘除术治疗,联合组运用后路颈椎经皮全内镜下髓核摘除术联合小针刀技术治疗,观察并比较两组患者的临床疗效总有效率、肩颈部疼痛程度(VAS评分)、镇痛效果(疼痛缓解率)以及症状功能评分(眩晕、头痛、旋颈试验)。结果:联合组的总有效率(92.5%)高于手术组(70.0%),联合组治疗后的肩颈部疼痛评分低于手术组,联合组的疼痛缓解率(97.5%)高于手术组(85.0%),联合组患者治疗后的症状功能评分低于手术组,差异均有统计学意义(P0.05)。结论:后路颈椎经皮全内镜下髓核摘除术联合小针刀技术治疗神经根型颈椎病的短期疗效显著,能够有效缓解患者的肩颈部疼痛,提高镇痛效果,降低症状功能评分,值得临床推广应用。     

射频热凝靶点消融术联合臭氧注射治疗神经根型颈椎病

目的评价射频热凝靶点消融术联合臭氧注射治疗神经根型颈惟病的疗效。方法对35例神经根型颈椎病的患者,在C型臂X线机引导下经皮穿刺椎间盘靶点,先行射频热凝靶点消融术,然后在椎间盘内注射臭氧,术后1周、1个月、1年进行疗效评价。结果随访时间9～24个月,平均13.2个月。视觉模拟评分术后评分与术前比较有显著性差异（P〈0.01）。患者主观满意度优良率94.3%。术后未发生不良反应和其他并发症。结论射频热凝靶点消融术联合臭氧注射治疗神经根型颈椎病,是一种有效、微创和安全的治疗方法。对于保守治疗无效而又不适于于术治疗的神经根型颈椎病患者,只要严格掌握适应证,是一个值得推荐的治疗选择。     

后路单开门Centerpiece内固定治疗多节段脊髓型颈椎病

目的探讨颈后路单开门结合Centerpiece钛板内固定术治疗多节段脊髓型颈椎病的临床疗效和安全性。方法自2010年5月至2012年5月,采用颈后路单开门结合Centerpiece钛板内固定术治疗多节段脊髓型颈椎病患者32例,男20例,女12例;年龄49~77岁,平均(60.4±7.6)岁。以日本骨科协会(Japanese orthopaedic association,JOA)17分法评定神经功能,在侧位X线片上测量C2与C7椎体后壁切线夹角α确定颈椎曲度,以过伸过屈位α的差异来计算颈椎活动度,以颈肩疼痛视觉模拟评分(visual analogue scale,VAS)评估。结果手术均顺利完成,手术时间100~160 min,平均140 min;手术失血量250~800 mL,平均460 mL。所有患者均获得随访,随访时间12~38个月,平均22个月。术前和术后1周JOA分别为(9.26±3.16)分、(12.95±2.35)分(P0.05),JOA改善率为(56.4±9.3)%;术后3个月和术后1年JOA分值分别为(13.30±2.46)分、(13.16±1.39)分,与术后1周(12.95±2.56)分相比,差异均无统计学意义(P0.05);患者术前、术后3个月颈椎曲度分别为(18.1±3.8)°和(16.7±5.4)°,两者差异无统计学意义(P0.05);患者术前、术后3个月颈椎活动度分别为(35.46±11.54)°和(30.65±8.95)°,两者差异无统计学意义(P0.05);术前、术后3个月平均颈肩部VAS评分分别为(3.8±1.8)分和(1.6±1.5)分,两者差异有统计学意义(P0.05)。结论颈后路单开门结合Centerpiece钛板内固定术治疗多节段脊髓型颈椎病能够有效改善多节段脊髓型颈椎病患者神经功能,保存颈椎曲度及活动度,是治疗多节段脊髓型颈椎病的有效方法。     

三维曲度牵引联合电针治疗神经根型颈椎病临床疗效观察

目的:观察三维曲度牵引联合电针治疗神经根型颈椎病的临床疗效。方法:将62例伴有颈椎曲度异常的神经根型颈椎病患者随机分为治疗组和对照组,每组31例。治疗组采用三维曲度牵引联合电针治疗,对照组采用普通坐位枕颌套牵引联合电针治疗。分别在治疗前、治疗后、疗程结束后3个月随访时对2组患者颈椎视觉模拟评分法(VAS)评分、颈椎曲度指数等指标进行观察;治疗后进行临床疗效评定。结果:治疗组痊愈17例,显效8例,有效4例,无效2例,总有效率为93.55%;对照组痊愈9例,显效7例,有效6例,无效9例,总有效率为70.97%。2组比较,差异有统计学意义(P<0.05)。治疗后及随访时,2组VAS评分、颈椎曲度指数较治疗前均有改善(P<0.05),且治疗组优于对照组(P<0.05)。随访时,2组VAS评分、颈椎曲度指数与治疗后比较,差异均有统计学意义(P<0.05)。结论:三维曲度牵引联合电针治疗神经根型颈椎病能明显改善患者的临床症状,纠正或改善患者的异常颈椎曲度,疗效持久确切,值得临床推广使用。     

Anterior Cervical Discectomy and Fusion Combined with Foraminotomy Assisted by High‐Definition 3‐Dimensional Exoscope in the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis

ObjectiveTo evaluate the outcomes of cervical spondylotic radiculopathy secondary to bony foraminal stenosis treated with anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) assisted by High‐Definition 3‐Dimensional Exoscope.MethodsIn this retrospective study, a total of 19 consecutive patients (12 males and seven females, with an average of 49.2 years, range from 40 to 59 years) with spondylotic radiculopathy caused by bony foraminal stenosis underwent ACDF combined with ACF assisted by High‐Definition 3‐Dimensional Exoscope in our hospital between January 2019 and December 2019 were included in this study. All patients signed the consent form before the surgery. The patient baseline information such as gender, age, body mass index (BMI), surgery time, blood loss, hospital stay, lesion segment, side, follow‐up time and postoperative complications were recorded. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) were measured and compared before surgery, 1 months and final follow‐up after surgery. The radiographic outcomes were evaluated using the C₂‐C₇ angel, disc height, foraminal height, superior diagonal distance, inferior diagonal distance, and foraminal area.ResultsThe involved levels included C₄‐C₅ (six cases), C₅‐C₆ (10 cases), C₆‐C₇ (three cases). The mean duration of the surgery, mean blood loss, mean hospital stay, and mean follow‐up were 100 ± 11.10 min, 19.4 ± 7.05 mL, 7.1 ± 0.99 days, and 12.1 ± 2.25 months, respectively. The average preoperative JOA score was 11.9 ± 1.31, then improved to 15.7 ± 0.73 (t = −13.45, P < 0.001) and 16.2 ± 0.74 (t = −14.39, P < 0.001) at 1 month after operation and at last follow‐up, respectively. The average preoperative NDI score was 27.3 ± 3.36, then decreased to 5.1 ± 1.79 (t = 20.63, P < 0.001) and 4.5 ± 1.21 (t = 25.53, P < 0.001) 1 month after operation and at last follow‐up, respectively. The average preoperative VAS score was 6.7 ± 0.93, then decreased to 2.4 ± 0.69 (t = 15.05, P < 0.001) and 1.9 ± 0.78 (t = 16.40, P < 0.001) 1 month after operation and at last follow‐up, respectively. As compared with the condition before surgery, there was a significant improvement in the C₂‐C₇ angel, disc height, foraminal height, and foraminal area (P < 0.05). None of the patients developed postoperative vascular injury, nerve injury, loosening and rupture of the internal fixation, displacement of interbody fusion cage, and pseudarthrosis.ConclusionACDF combined with ACF assisted by High‐Definition 3‐Dimensional Exoscope is effective and safe for the treatment of CSR caused by secondary to bony foraminal stenosis.