目的:观察微创颈后路椎间孔切开术(MI-PCF)和颈前路椎间盘切除融合术(ACDF)治疗单节段单侧神经根病(SLUCR)的临床疗效和安全性。
方法:我们回顾性分析了2020年2月至2022年2月两家医院的81例SLUCR患者,包括MI-PCF组(n=40)和ACDF组(n=41)。颈部和肩部疼痛的差异,视觉模拟评分(VAS),上肢放射痛(VAS),比较颈部残疾指数(NDI)。手术时间,术中出血,住院,比较两组患者的并发症。
结果:ACDF组术后1天的颈肩疼痛缓解程度优于MI-PCF组(p<0.05),而两组在1个月时颈肩疼痛缓解方面无显著差异,3个月,6个月,术后12个月,(p>0.05)。1天时两组上肢放射痛的缓解和NDI评分的降低无显著性差异,1个月,3个月,6个月,术后12个月(p>0.05)。MI-PCF组患者手术时间短,出血少,缩短住院时间,差异有统计学意义(p<0.05)。两组并发症发生率无统计学差异。(p>0.05)。
结论:MI-PCF和ACDF治疗SLUCR的临床疗效和安全性均满意。同时,MI-PCF手术时间短,与ACDF相比,出血少,住院时间短,值得临床推广。
OBJECTIVE: The aim of this study was to observe the clinical efficacy and safety of minimally invasive posterior cervical foraminotomy (MI-PCF) and anterior cervical discectomy and fusion (ACDF) in the treatment of single-level unilateral cervical radiculopathy (SLUCR).
METHODS: We retrospectively analyzed 81 patients with SLUCR in two hospitals from February 2020 to February 2022, including the MI-PCF group (n=40) and the ACDF group (n=41). The differences in neck and shoulder pain, visual analog score (VAS), upper limb radiating pain (VAS), and neck disability index (NDI) were compared. Operative time, intraoperative bleeding, hospital stay, and complications were also compared between the two groups.
RESULTS: The degree of neck and shoulder pain relief at 1 day postoperatively was better in the ACDF group than in the MI-PCF group (p<0.05), while there were no significant differences between the two groups in terms of neck and shoulder pain relief at 1 month, 3 months, 6 months, and 12 months postoperatively, (p>0.05). There were no significant differences in the relief of upper limb radiating pain and the decrease of NDI scores between the two groups at 1 day, 1 month, 3 months, 6 months, and 12 months after surgery (p>0.05). The patients in MI-PCF group had shorter operative time, less bleeding, and shorter hospital stay, which were statistically different (p<0.05). There was no statistical difference in the complication rate between the two groups, (p>0.05).
CONCLUSIONS: The clinical efficacy and safety of MI-PCF and ACDF in the treatment of SLUCR are satisfactory, meanwhile, MI-PCF has shorter operative time, less bleeding and shorter hospital stay than ACDF, which is worthy of clinical promotion.