经皮激光椎间盘减压术治疗颈性眩晕的中期疗效观察

目的:观察分析经皮激光椎间盘减压术治疗颈性眩晕的中期临床疗效。方法:2002年9月至2006年12月收治35例颈性眩晕患者,男14例,女21例,年龄35～79岁,平均59.1岁。均使用Nd:YAG激光治疗机(波长1064nm)行经皮激光椎间盘减压术治疗,随访观察治疗效果。应用数字评分法(NRS)评价眩晕及伴随症状的改善情况,应用改良Macnab评价标准进行优良率和有效率的评估。结果:患者术中及术后均未见神经损伤、感染等并发症发生。随访24～66个月,平均41.8个月。末次随访时,35例患者的眩晕及伴随症状的平均NRS评分较术前明显下降(P0.01)。患者总体疗效依据改良MacNab评价标准,优18例,良7例,可5例,差5例,总体优良率为71.43%,总体有效率为85.71%。60岁组和≤60岁组患者比较,优良率分别为75.0%和68.4%,有效率分别为81.25%和89.47%,两组比较差异无统计学意义(P0.05);男性组和女性组患者比较,优良率分别为85.71%和61.90%,有效率分别为85.71%和85.71%,两组比较差异无统计学意义(P0.05)。结论:应用经皮激光椎间盘减压术治疗颈性眩晕创伤小,安全性高,中期疗效较满意,不同年龄组及不同性别组患者的中期临床疗效均无明显差异。

Percutaneous laser disc discectomy for cervical vertigo,mid-term outcome

Objective:To review the mid-term outcome of pereutaneous laser disc discectomy (PLDD) for cervical vertigo.Method:From September 2002 to December 2006,thirty five patients with cervical vertigo undergoing PLDD(Nd:YAG laser,wavelength 1064nm) were reviewed retrospectively,there were 14 males and 21 females with the mean age of 59.1 years (range,35 to 79 years old).The improvement of each patient's symptoms were estimated using number rating scale (NRS) criteria and the excellent to good rate were reviewed by modified Maenab criteria.Result:No neurovascular injury and infection was noted.All patients were followed up for 24 to 66 month(mean,41.8 months).At final follow-up,the NRS score were significantly lower than preoperative counterpart (P<0.01).Aecording to modified Maenab criteria,18 was rated as excellent,7 as good,5 as fair and 5 as poor with the total excellent and good rate of 71.43% and the effective rate of 85.71%,no significant difference was noted between groups with age above and below 60 with regard to the excellent to good rate and the effective rate (P>0.05).The excellent to good rate with regard to male and female was 85.71% and 61.90% respectively,and the effective rate for male and female was 85.71% and 85.71% respectively,no significant difference was noted between two groups (P>0.05).Conclusion:PLDD for cervical vertigo is reliable and minimal invasive,which show good mid-term outcome and no sex-related difference.