经皮颈椎后路内镜技术治疗单节段不完全性无骨折脱位型颈脊髓损伤的疗效分析

doi:10.3969/j.issn.2095-378X.2021.04.005

Abstract

Abstract: Objective To investigate the clinical efficacy of percutaneous posterior endoscopic cervical discectomy （PPECD） on incomplete single-segment spinal cord injury without radiographic abnormality （SCIWORA） and its complications. Methods A total of 51 patients with SCIWORA from January 2017 through December 2019 were divided into a control group and an observation group according to the random number table method. The observation group （n=21） received PPECD, and the control group （n=30） received anterior cervical discectomy fusion （ACDF）. Follow up lasted 3 months. Operation time, intraoperative blood loss volume, and fluoroscopy times were recorded. The VAS scores of neck and upper limbs, JOA scores of neck, cervical Cobb angle, and range of motion （ROM） in the two groups before and 3 months after operation were recorded and compared. The incidence rate of postoperative complications was also recorded and compared. Results There were significant differences between the two groups in intraoperative blood loss volume and fluoroscopy times （P<0.05）. At 3 days and 3 months after operation, the VAS scores and JOA scores were improved compared with the scores before operation （P<0.05）, but there was no significant difference between the two groups （P>0.05）. The cervical Cobb angle and ROM of the two groups were improved 3 months after operation （P<0.05）, and observation group had greater improvement than the control group （P<0.05）. No epidural hematoma or neurodural injury occurred in the two groups. In control group, 1 case of incision infection （3.33%） and 3 cases of incision edema （10.00%） occurred within 3 months after operation. Conclusion The short-term clinical efficacies of PPECD and ACDF on SCIWORA are similar. PPECD features less intraoperative blood loss but more times of fluoroscopy. Although both surgeries can improve cervical Cobb angle and ROM, but PPECD has greater effects and produces less postoperative complications than ACDF.

Key words: Spinal cord injury without radiographic abnormality, Percutaneous posterior endoscopic cervical discectomy, Clinical efficacy, Range of motion

CLC Number:

R816.8

SHEN Xiang, LI Chengcun, ZHANG Yang, SUN Yinming, WANG Wenqiang. Clinical efficacy of percutaneous posterior endoscopic cervical discectomy on incomplete single-segment spinal cord injury without radiographic abnormality[J]. Surgical Research and New Technique, 2021, 10(4): 260-265.

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Clinical efficacy of percutaneous posterior endoscopic cervical discectomy on incomplete single-segment spinal cord injury without radiographic abnormality

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