神经根型颈椎病的微创治疗

目的探讨经后路微创手术治疗神经根型颈椎病的疗效。方法采用后方小切口入路对32例神经根型颈椎病患者实行经后路微刨手术治疗,并对手术效果进行了临床随访观察。结果对14例年轻患者黄韧带增厚不明显、椎间盘质地较软者,在椎间孔扩大的同时行突出椎问盘切除,其余18例老年患者则因局部黄韧带明显增厚并有骨化,椎间盘质地较韧,切除困难,故只行椎间孔扩大,神经根减压;术后所有患者神经根痛症状均有改善,对28例患者进行了3～16个月的随访,术后没有出现颈部活动障碍和临床症状的复发。结论采用微刨手术治疗神经根型颈椎病,创伤小、安全、简捷、有效,一次手术即可切除绝大部分突出的椎间盘,在不影响颈椎稳定性的同时又完成了神经根减压

Minimally-invasive surgical treatment of cervical radiculomyelopathy

OBJECTIVE: To discuss the effect of the posterior minimally-invasive surgical treatment of root type cervical spondylotic myelopathy. METHODS: A posterior minimally-invasive operation was given to 32 nerve root type cervical spondylotic myelopathy patients, and the clinical result was followed. RESULTS: An operation of enlargement of intervertebral foramen and disc excision was given for 14 young patients whose ligamentum flavum incrassated a little and the disc was soft. An operation of enlargement of intervertebral foramen only was given for 18 old patients whose ligamentum flavum incrassated much with ossification, and the disc was tenacious. All the patients' sign of nerve root was improved after operation. Twenty-eight patients were followed up 3 to 16 months, and there were no obstacle of neck movement and recurrence of clinical sign. CONCLUSION: This method for the posterior minimally-invasive neurosurgical operations of cervical spondylotic myelopathy is safe, simple and effective. By this operation, we can removal most of the herniative cervical disk and decompression for the nerve root and get good stable of spondylopathy.