摘要
目的 :探讨经皮穿刺颈椎间盘切除术 (PCD)治疗由颈椎间盘突出引起的早期颈椎病的适应证以及对颈椎稳定性的影响。方法 :把 16 8例PCD病例对比研究 ,根据X光片 (包括动力侧位片 )、CT或MRI抽选为Ιa、Ⅱa两组 (可重复 )及其对照组Ιb、Ⅱb。Ιa组 6 0例 :伴有颈椎骨质增生的颈椎病病例。相同例数单纯颈椎间盘膨出或突出病例为Ιa组的对照组Ιb ;Ⅱa组 5 6例 :相邻颈椎椎体成角 >110及位移 >2mm的颈椎病病例。相同例数测量阴性的颈椎病为B组的对照组Ⅱb。术后随访 6个月～ 7年临床分析。结果 :术后优良率 :Ιa组只有 5 6 .7% ,而Ιb组 93.3%。两组之间差别有显著性 (P <0 .0 5 )。Ⅱa组 83.9% ,术后颈椎失稳程度无加重 ,Ⅱb组 87.5 % ,两组之间差别无显著性 (P >0 .5 )。结论 :只要掌握好手术指征 ,PCD对于早期颈椎病是一种具有临床价值的治疗方法 ,且不影响颈椎的稳定性 ,颈椎失稳对PCD的疗效无影响。
Objective:To understand therapeutic effect of percutaneous cervical discectomy (PCD) on early cervical spondylosis resulted from cervical disc herniation.Methods: X ray film and CT or MIR of 168 patients, who had been treated by PCD, were designed in the Ia group (60cases) in which the patients have cervical spondylosis with osteophytosis and the Ⅱa group (56 cases) in which the patients have cervical spondylosis with the disk space angle >110and dislocation >2mm between the adjacent vertebral bodies and Ib (60 cases) and Iib (60 cases) as control groups. All subjects received the follow up for 6 months at least.Results: The post-operation excellent rate reached about was 56.7% in Ιa group and 93.3% in Ιb group, there was a difference between the two groups (P<0.05). The post-operation excellent rate was 83.9% in Ⅱa group. No deterioration of cervical spinal stability was discovered after the procedure. The rate was 87.5% in Ⅱb group. No remarkable changes(P>0.5)were found between the two groups.Conclusions: PCD is a valuable method for treatment of early cervical spondylosis and could not compromise spinal stability as long as the surgical indications were grasp well. The effectiveness with unstable cervical spine is not changed obviously after PCD.
出处
《青海医药杂志》
2004年第1期7-10,共4页
Qinghai Medical Journal
