本文選題：低溫等離子髓核消融術(shù) + 神經(jīng)根型頸椎病　； 參考：《中國(guó)微創(chuàng)外科雜志》2017年05期

【摘要】：目的觀察低溫等離子髓核消融術(shù)(percutaneous cervical disc nucleoplasty,PCDN)治療神經(jīng)根型頸椎病(cervical spondylotic radiculopathy,CSR)的中期臨床療效。方法 2010年4月~2013年6月我科采用PCDN在局麻和影像學(xué)監(jiān)視下靶向穿刺,消融及熱凝(射頻能量100 Hz)治療CSR 231例,其中135例獲得2年以上隨訪,采用日本整形外科田中靖久(Yasuhisa Tanaka)的癥狀量化表20分法(簡(jiǎn)稱(chēng)YT 20分法)、改良Mac Nab評(píng)分法對(duì)術(shù)后1、3、6、12、24個(gè)月和末次隨訪的療效進(jìn)行評(píng)價(jià)。結(jié)果均為單節(jié)段手術(shù),其中C_(4~5)32例,C_(5~6)64例,C_(6~7)39例。術(shù)后未發(fā)生神經(jīng)根損傷、大血管破裂、穿刺點(diǎn)感染及椎間隙感染等并發(fā)癥。135例門(mén)診隨訪2~5年1個(gè)月,中位數(shù)3.2年。術(shù)后1、3、6、12、24個(gè)月YT 20評(píng)分分別為(14.35±4.47),(14.82±4.94),(15.71±5.43),(15.77±5.56),(15.29±5.64)分,均較術(shù)前(8.87±4.29)分明顯提高(P均=0.000);術(shù)后1、3、6、12、24個(gè)月YT 20分法優(yōu)良率分別為47.4%(64/135)、57.0%(77/135)、65.9%(89/135)、65.2%(88/135)、61.5%(83/135),有效率分別為77.0%(104/135)、78.5%(106/135)、77.0%(104/135)、74.8%(101/135)、71.9%(97/135),術(shù)后3、6、12、24個(gè)月YT 20分法療效均明顯優(yōu)于術(shù)后1個(gè)月(P0.05)。術(shù)后復(fù)發(fā)27例,占20.0%(27/135)。術(shù)后1、3、6、12、24個(gè)月改良Mac Nab療效評(píng)價(jià),優(yōu)良率分別為64.4%(87/135)、65.2%(88/135)、70.4%(95/135)、67.4%(91/135)、64.4%(87/135),有效率分別為85.2%(115/135)、85.2%(115/135)、83.0%(112/135)、80.7%(109/135)和78.5%(106/135);術(shù)后3、6、12個(gè)月改良Mac Nab療效均明顯優(yōu)于術(shù)后1個(gè)月(P0.05),術(shù)后6、12個(gè)月分別優(yōu)于術(shù)后3、24個(gè)月(P0.05)。結(jié)論 PCDN能明顯改善CSR患者頸肩背部及上肢酸脹、疼痛、麻木等癥狀,提高患者的日常生活與工作能力,中期療效滿(mǎn)意。
[Abstract]:Objective to observe the intermediate clinical effect of hypothermia plasma ablation (percutaneous cervical disc) on (cervical spondylotic radiculopathy (cervical spondylotic) of cervical spondylosis. Methods from April 2010 to June 2013, 231 cases of CSR were treated with PCDN under the surveillance of local anesthesia and imaging monitoring. Among them, 135 cases were followed up for more than 2 years. The modified Mac-Nab scoring method was used to evaluate the curative effect of 12 months, 24 months and the last follow-up of Yasuhisa Tanaka, a Japanese plastic surgery, with the modified Mac Nab scoring method. Results all of them were single segmental operation, of which 32 cases were C4F5, 64 cases were C6, and 39 cases were C6F7. There were no complications such as nerve root injury, major vascular rupture, puncture site infection and intervertebral space infection. 135 cases were followed up for 2 ~ 5 years and 1 month, median 3.2 years. 鏈悗1,3,6,12,24涓湀YT 20璇勫垎鍒嗗埆涓，

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