内窥镜技术在颈椎前路手术中的应用

目的：探讨内窥镜下颈椎前路减压植骨融合术的手术技巧与疗效。方法：2002年8月～2005年3月应用内窥镜下颈椎前路减压植骨融合术治疗20例颈椎疾患患者，均应用自制不同型号椎间旋转撑开器及特制不同角度、不同大小的网形与方形刮匙行前路椎间盘切除，单纯PEEK cage植骨融合8例，PEEK cage植骨融合加钛板内同定2例，单纯钛cage植骨融合3例，钛cage植骨融合加钛板内同定2例，椎间植骨融合加钛板内同定5例，随访观察治疗效果。结果：术后随访3～12个月，平均7个月。患者症状体征及神经功能均明显改善。术后影像学检查手术部位减压彻底。1例发生钛cage松动，其余椎间高度无丢失，维持颈椎正常生理曲度。结论：通过对椎间盘镜部分器械和技术的改进，将其应用于颈椎前路椎间盘切除、椎间融合内同定术治疗颈椎病及颈椎间盘突出症可取得满意的效果。

Anterior cervical endoscopic discectomy and interbody fusion

Objective:To explore the technique and outcomes of the anterior cervical endoscopic discectomy and interbody fusion.Method:A total of 20 patients with protrusion of cervical disc or cervical spondylotic myelopathy undertaking anterior cervical endoscopic discectomy and interbody fuson with PEEK cage,titanium cage and titanium plate individually in over 2 years were reviewed retrospectively.Of these patients,single PEEK cage was applied in 8 cases,PEEK cage plus anterior plate in 2 cases,single titanium cage in 3 cases,titanium cage plus anterior plate in 2 case,intervertebral bone graft plus anterior plate in 5 cases.Result:All 20 patients were followed-up for 3~12 months(average,7 months).The neurological function of 20 patients improved significantly after operation,the radiological results showed no intervertebral height loss except 1 case with instrument failure,physical curve was maitained in all cases,and completely decompression were reached in all cases,no instrument failure was documented except of internal fixation loosening in 1 case.Conclusion:With the improvement of technique and instrument,the procedures including anterior cervical discectomy,interbody fusion and internal fixation under endoscopy can be used to deal with cervical diseases effectively.