经皮髓核成形术治疗退变性颈椎间盘突出症

目的: 探讨经皮髓核成形术对不同退变程度颈椎间盘突出症的临床疗效及颈椎稳定性的影响。方法: 对我院2003 年12月～2006 年12 月因退变性颈椎间盘突出症住院行PCN治疗的88 例患者进行回顾性分析, 椎间盘退变程度根据MRI分为中度组(median Degeneration group, MDG)与重度组( severe degeneration group，SDG) , 对两组手术时间、临床效果及术后颈椎稳定性等方面进行比较。结果: 所有病例随访6～30 个月, 两组手术均成功。MDG手术时间为14．67±5.32min, SDG为13.93±3.96min, 两组间有显著性差异( P<0.01)；两组术后JOA评分均显著增高, 与术前比较有显著性差异( P<0.01) ；临床效果(Williams评价)MDG优于SDG, 有显著性差异( P<0.05)。两组手术后均无颈椎不稳病例发生,各手术间隙的椎体角度位移( angular displacement, AD) 及椎体水平位移( horizontal displacement, HD) 手术前后均无显著性差异( P>0.05) 。结论:经皮髓核成形术对颈椎稳定性影响小, 不会造成颈椎失稳的发生，适用于不同退变程度的颈椎间盘突出症。早期手术治疗可取得较好的临床疗效好

Treatment of degenerative cervical disc herniation by percutaneous cervical Nucleoplasty

Objective: To discuss the therapeutic outcome of percutaneous cervical Nucleoplasty ( PCN) for the degenerative cervical disc herniation and its impact on the cervical spinal stability.Method: 88 cases with degenerative cervical disc herniation operated with PCN from Decenber 2003 to December 2006 were reviewed.According to the demonstration of MRI, these cases were divided into median degenerative group(MDG) and severe degenerative group( SDG) .The time of operation, clinical outcome and the stability of cervical spine after operation were evaluated and compared between two groups.Result: All cases were followed up for 6 months to 30 months.All cases were successfully operated.The operation time for MDG was (14．67±5.32)min, SDG(13.93±3.96)min, and there was significant difference between two groups ( P<0.01) .There was significant difference in the pre- and post- operation JOA scores of each group( P<0.01) . For the Williams score, the MDG clinical outcome outscored the SDG, which had significant difference( P<0.05) .No instability of cervical spine, no angular or horizontal displacement postoperation was observed in each group( P>0.05) .Conclusion: Treatment of degenerative cervical disc herniation with PCN has good outcomes and no effect on the stability of cervical spine.PCN is a safe, minimally invasive operation with less traum and excellent clinical outcome.