颈椎后椎间孔切开术治疗无脊髓病的颈椎神经根病的前瞻性研究

Umesh Jain, Amol Gowaikar, P. Patil, U. Ghate, Rishabh Nair
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摘要

目的:探讨无脊髓型颈椎病患者行颈椎后路椎间孔切开术(PCF)后的临床和患者满意度。评价PCF的疗效。方法:这是一项前瞻性多中心研究,纳入了2020年10月至2022年11月在“骨科”接受PCF手术的颈椎单根病患者。对医院记录、影像、手术笔记和随访记录进行了回顾和分析。本文对30例颈椎单根病进行了研究。所有在2020年10月至2022年11月研究期间符合纳入标准的患者纳入研究。考虑了任何年龄组、性别和因PCF手术的患者。然后,借助医院记录、图像、手术笔记和访谈,对这些患者进行了细致的彻底检查。所有患者的详细信息均根据既往医院记录和与患者的互动以及颈部残疾指数(NDI)评分获得。讨论:神经根减压可采用前路或后路入路。前路有损伤食道、气管、颈动脉鞘及喉返神经的风险,后路包括椎间孔切开术,钻取部分小关节及邻近椎板,在特定情况下也可切除椎间盘,该入路风险不大。许多比较研究显示pcf(后颈椎椎间孔切开术)与acdf(前颈椎椎间盘切除术融合术)的疗效相同。结果:当我们在不同的时间间隔分析NDI评分时,有一个积极的趋势显示个体患者的整体健康状况有所改善,这导致作为样本的主要患者已经恢复了他们以前的正常日常生活,在患颈椎神经根病之前。结论:对术前i-e、即刻、术后、术后6周、术后3个月、术后6个月不同时间间隔的NDI评分进行分析,最终得出患者每次随访均有连续改善的结论。
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Prospective study of posterior cervical foraminotomy for cervical radiculopathy in absenceof myelopathy
Objective: To determine clinical and patient satisfaction outcomes after posterior cervical foraminotomy (PCF), for the patients suffering from cervical monoradiculopathy, in the absence of myelopathy. To assess the efficacy of PCF. Methods: This was a prospective and multicentric study including patients of cervical monoradiculopathy, who underwent PCF surgery in the “department of orthopedics,” between October 2020 and November 2022. The hospital records, images, operation notes, and follow-up records were reviewed and analyzed. Thirty patients of cervical monoradiculopathy were investigated. All the patients who have satisfying inclusion criteria in the study period from October 2020 to November 2022 were included in the study. Patients of any age group and both the sexes and who were operated for PCF were considered. Those patients were then meticulously subjected to thorough inspection, with the help of hospital records, images, and operation notes and interviews. All the details of the patients were obtained based on previous hospital records and interactions with them and through neck disability index (NDI) score. Discussion: Decompression of the nerve root can be done by either anterior or posterior approach. Anterior approach carries risk of damaging oesophagus, trachea, carotid sheath and recurrent laryngeal nerve posterior approach includes foraminotomy in form of drilling some part of facet joint and adjacent lamina, disc can also be removed in selected cases this approach do not carry much risk. Many comparative studies shows equal beneficial outcome of pcf (posterior cervical foraminotomy)as compared to acdf (anterior cervical disectomy with fusion). Results: When we analyzed the NDI scores at different intervals there has been a positive trend showing the improvement in overall well being of an individual patient and this has resulted in major porting of the patients that has been taken as a sample has returned to there normal day to day living which they used to have earlier, before suffering from cervical radiculopathy. Conclusion: The final conclusion that can be drawn after analyzing the NDI score at different interval of time i-e before surgery, immediately and after surgery, 6 weeks post surgery, 3 months post surgery and 6 months post surgey is that patients have shown successive improvements with every follow up done.
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