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(P<0.05)。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。

Short-term Efficacy of Cervical Posterior Transforaminal Window Decompression and Nucleus Pulposus Removal Combined with Small Needle Knife Technique in the Treatment of Cervical Spondylotic Radiculopathy

Objective To observe the short-term effect of posterior cervical percutaneous total endoscopic nucleus pulposus removal combined with small needle knife technique in the treatment of cervical spondylotic radiculopathy and to explore the treatment of this disease,so as to promote the recovery of patients as soon as possible.Methods 80 cases of cervical spondylotic radiculopathy were randomly divided into operation group and combined group.Each group consisted of 40 cases.The operation group was treated by posterior cervical percutaneous endoscopic nucleus pulposus excision.The combined group was treated by posterior cervical percutaneous endoscopic nucleus pulposus excision combined with small needle knife technique.After treatment,the total effective rate,the degree of shoulder and neck pain(VAS score),the analgesic effect(pain relief rate)and the symptom function score(vertigo,headache,neck rotation test)were compared between the two groups.Results The total effective rate(92.5%)of the combined group was higher than that of the operation group(70.0%).The pain relief rate(97.5%)of the combined group was higher than that of the operation group(85.0%).The symptom function score of the combined group was lower than that of the operation group(P<0.05).Conclusion Posterior cervical percutaneous total endoscopic nucleus pulposus excision combined with small needle knife technique in the treatment of cervical spondylotic radiculopathy has a significant short-term effect,which can effectively alleviate shoulder and neck pain,improve analgesic effect,reduce symptoms and functions score.It is worthy of clinical implementation.