单侧双通道脊柱内镜下后方减压联合颈椎前路椎间盘切除融合术治疗多节段混合型颈椎病二例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

付豪 ^1,2 , 胡宇童 ^1,2 , 杨东方 ² ,  许卫兵 ²

1. ;
2. ;

Corresponding author：

许卫兵, Email: xuweibingsmmu@163.com

Keywords：

单侧双通道脊柱内镜技术; 多节段混合型颈椎病; 颈椎前路椎间盘切除融合术; 颈椎后路椎间孔切开减压术; 联合手术

DOI：

10.7507/1002-1892.202205137

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目的总结单侧双通道脊柱内镜下颈椎后路椎间孔切开减压术（unilateral biportal endoscopic posterior cervical foraminotomy，UBE-PCF）联合颈椎前路椎间盘切除融合术（anterior cervical discectomy and fusion，ACDF）治疗2例多节段混合型颈椎病的经验。方法 2022年2月及3月收治2例多节段脊髓型颈椎病、神经根型颈椎病及退行性颈椎滑脱患者。男、女各1例；年龄分别为59、66岁。患者上肢感觉减退、Hoffmann征阳性，影像学检查示颈椎不稳、椎间盘突出以及左侧椎间孔狭窄。全身麻醉下对相应病变节段行ACDF以及UBE-PCF。结果 2例手术时间分别为186、145 min，术后切口Ⅰ期愈合。患者均获随访3个月。术后2 d及3个月疼痛视觉模拟评分（VAS）、颈椎功能障碍指数（NDI）均较术前下降，日本骨科协会（JOA）评分较术前上升。影像学复查示治疗节段神经减压彻底，未出现颈椎不稳。结论对于伴退行性颈椎滑脱的多节段混合型颈椎病，ACDF联合UBE-PCF能选择性处理不同节段病变，最大程度保留脊柱功能，获得良好近期疗效。

Citation： 付豪, 胡宇童, 杨东方, 许卫兵. 单侧双通道脊柱内镜下后方减压联合颈椎前路椎间盘切除融合术治疗多节段混合型颈椎病二例. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(10): 1241-1243. doi: 10.7507/1002-1892.202205137 Copy

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1. Luo CA, Lim AS, Lu ML, et al. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep, 2022, 12(1): 4495. doi: 10.1038/s41598-022-08243-8.
2. Gatam AR, Gatam L, Phedy, et al. Full endoscopic posterior cervical foraminotomy in management of foraminal disc herniation and foraminal stenosis. Orthop Res Rev, 2022, 14: 1-7.
3. Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine (Phila Pa 1976), 2015, 40(12): E675-E693.
4. Ninomiya K, Yamane J, Aoyama R, et al. Clinical effects of anterior cervical spondylolisthesis on cervical spondylotic myelopathy after posterior decompression surgery: A retrospective multicenter study of 732 cases. Global Spine J, 2022, 12(5): 820-828.
5. Yuan H, Zhang X, Zhang LM, et al. Comparative study of curative effect of spinal endoscopic surgery and anterior cervical decompression for cervical spondylotic myelopathy. J Spine Surg, 2020, 6(Suppl 1): S186-S196.

Chinese Journal of Reparative and Reconstructive Surgery

单侧双通道脊柱内镜下后方减压联合颈椎前路椎间盘切除融合术治疗多节段混合型颈椎病二例

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