本文選題：低溫等離子髓核消融術 + 頸性眩暈��； 參考：《中國脊柱脊髓雜志》2016年04期

【摘要】：目的:觀察低溫等離子髓核消融術(percutaneous cervical discnucleoplasty,PCDN)治療頸性眩暈近期臨床療效。方法:2010年4月~2013年3月我科采用PCDN治療頸椎病患者295例,其中頸性眩暈患者92例,61例獲得2~3.9年(平均2.7±0.52年)隨訪,男性20例,女性41例,年齡33~81歲,平均(57.28±10.55)歲,采用改良頸性眩暈及伴隨癥狀評估量表評價術后即刻、術后3個月、術后12個月和末次隨訪時的有效率。結果:所有患者術中、術后均無神經損傷、感染等并發(fā)癥發(fā)生。術后即刻、術后3個月、術后12個月和末次隨訪時,61例患者的眩暈及伴隨癥狀的平均改良評分分別為21.75±1.76、25.00±4.00、24.82±4.38、24.64±4.12分,均較術前(18.06±3.25分)明顯上升,有效率分別為96.7%、75.4%、72.1%、72.1%。末次隨訪時,眩暈癥狀消失或明顯緩解的患者占72.1%(44/61),其中治療節(jié)段包含C3/4或C4/5節(jié)段者43例(C4/5 30例,C3/4 4例,C3/4、C4/5 9例);C5/6、C6/7 1例。4例患者于術后12個月前后眩暈癥狀復發(fā),復發(fā)率占6.6%,其中3例予以保守治療,另1例行頸椎人工間盤置換術,經治療后癥狀均獲得明顯改善。17例隨訪無效的患者中,4例患者術前TCD顯示椎-基底動脈狹窄或椎動脈狹窄;5例患者年齡偏高,術前均合并有高血壓病3級;其他患者原因不明。結論:利用PCDN治療頸性眩暈可以獲得較好的近期臨床療效;選擇C3/4和/或C4/5節(jié)段是取得療效的關鍵。
[Abstract]:Objective: to observe the clinical effect of low temperature plasma nucleus pulposus ablation (cervical discnucleoplasty PCDN) in the treatment of cervical vertigo. Methods: from April 2010 to March 2013, 295 patients with cervical spondylosis were treated with PCDN. Among them, 92 patients with cervical vertigo were followed up for 2 ~ 3.9 years (mean 2.7 鹵0.52 years). There were 20 males and 41 females, aged 3381 years with an average of 57.28 鹵10.55 years. The efficacy of modified cervical vertigo and associated symptom assessment scale was evaluated immediately after operation, 3 months after operation, 12 months after operation and at the last follow-up. Results: no nerve injury, infection and other complications occurred in all patients during and after operation. Immediately after operation, 3 months after operation, 12 months after operation and the last follow-up, the average improvement scores of vertigo and associated symptoms in 61 patients were 21.75 鹵1.76 鹵25.00 鹵4.00 鹵24.82 鹵4.38 鹵24.64 鹵4.12, respectively, which were significantly higher than those before operation (18.06 鹵3.25). The effective rates were 96.75.45.40.72.41 and 72.1respectively. At the last follow-up, there were 72.1% of the patients who had disappeared or obviously relieved of dizziness, and 44 / 61% of them were treated with C _ 3 / 4 or C _ 4 / 5 segments, 43 cases with C _ 4 / 5 segment or C _ 4 / 5 segment C _ 4 / 30 cases with C _ 3 / 4% C _ 3 / 4 cases with C _ 3 / 4% C _ 4 / 4, 9 cases with C _ 5 / 6 C _ 6 / R _ 7, 4 cases with recurrent vertigo symptoms before and after 12 months of operation. The recurrence rate was 6.6%, of which 3 cases were treated conservatively and 1 case underwent cervical intervertebral disc replacement. After treatment, the symptoms were significantly improved. Among the 17 patients with ineffective follow-up, 4 patients with vertebrobasilar artery stenosis or vertebral artery stenosis showed that 5 patients with vertebrobasilar artery stenosis or vertebral artery stenosis had high age, and all patients had hypertension grade 3 before operation, while the other patients had unknown cause. Conclusion: the treatment of cervical vertigo with PCDN is effective in the short term, and the selection of C _ 3 / 4 and / or C _ 4 / 5 segments is the key to the treatment of cervical vertigo.
【作者單位】： 北京東直門醫(yī)院骨二科;
【分類號】：R687.3

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