CAJ | 학술논문

目的观察经皮激光椎间盘减压术(percutaneous laser disc decompression,PLDD)治疗神经根型颈椎病2～8年的随访结果,分析影响PLDD疗效的因素.方法对我院2002年12月至2009年6月应用PLDD治疗的58例神经根型颈椎病患者进行连续随访.男32例,女26例;平均年龄51.8岁(26～74岁).采用日本整形外科学会(Japanese Orthopedic Association,JOA)神经根型颈椎病疗效评定标准(20分法)和数字分级法(numeric rating scales,NRS)评价所有患者的术后疗效;比较不同性别、年龄及病程各亚组患者术后2年的JOA评分优良率.结果患者术后1个月、3个月、6个月、1年、2年、4年、6年和8年的JOA评分优良率分别为37.9％、51.7％、65.5％、81.0％、82.8％、80.9％、72.4％和72.7％,术后6个月至8年的各时间点与术后1个月比较,差异均有统计学意义(P＜0.05).术后末次随访各疼痛症状(颈痛、肩痛、上肢疼痛)的NRS评分均较术前下降,差异有统计学意义(P＜0.05).病程≤18个月患者术后2年JOA评分优良率(93.3％)高于病程＞18个月患者(71.4％),差异有统计学意义(P＜0.05).结论PLDD治疗神经根型颈椎病的中期疗效可靠、稳定,患者的病程长短可能会影响术后疗效.
목적 관찰경피격광추간반감압술(percutaneous laser disc decompression,PLDD)치료신경근형경추병2～8년적수방결과,분석영향PLDD료효적인소.방법 대아원2002년12월지2009년6월응용PLDD치료적58례신경근형경추병환자진행련속수방.남32례,녀26례;평균년령51.8세(26～74세).채용일본정형외과학회(Japanese Orthopedic Association,JOA)신경근형경추병료효평정표준(20분법)화수자분급법(numeric rating scales,NRS)평개소유환자적술후료효;비교불동성별、년령급병정각아조환자술후2년적JOA평분우량솔.결과 환자술후1개월、3개월、6개월、1년、2년、4년、6년화8년적JOA평분우량솔분별위37.9％、51.7％、65.5％、81.0％、82.8％、80.9％、72.4％화72.7％,술후6개월지8년적각시간점여술후1개월비교,차이균유통계학의의(P＜0.05).술후말차수방각동통증상(경통、견통、상지동통)적NRS평분균교술전하강,차이유통계학의의(P＜0.05).병정≤18개월환자술후2년JOA평분우량솔(93.3％)고우병정＞18개월환자(71.4％),차이유통계학의의(P＜0.05).결론PLDD치료신경근형경추병적중기료효가고、은정,환자적병정장단가능회영향술후료효.
Objective To observe the 2-8 years' follow-up results of percutaneous laser disc decompression(PLDD) on cervical spondylotic radiculopathy,and to identify factors affecting the outcome of PLDD.Methods Eighty-seven patients with cervical spondylotic radiculopathy were treated consecutively by PLDD in our hospital from December 2002 to June 2009,who were followed up for 2-8 years.There were 32males and 26 females,with the mean age of 51.8 years (range,26-74).The results were evaluated according to the Japanese Orthopedic Association's score of cervical spondylotic radiculopathy (JOA 20 score) and numeric rating scales (NRS) after surgery.Two years after the operation,the excellent and good rate of JOA score of patients with different genders,ages and duration of each subgroup will be compared.Results The excellent and good rate were 37.9％,51.7％,65.5％,81.0％,82.8％,80.9％,72.4％ and 72.7％ at 1,3,6months and 1,2,4,6,8 years after operation respectively.Significant difference was found between the time points of 6 months to eight years after operation and that of one month after operation.The NRS score of the pain symptoms at the final follow-up was significantly reduced (P＜0.05).The excellent and good rate of patients whose course of disease (93.3％) was less than 18 months was significantly higher than that of those whose course of disease was over than 18 months (71.4％) two years after operation (P＜0.05).Conclusion The intermediate-term curative effect of PLDD for the treatment of cervical spondylotic radiculopathy is reliable and stable,and the postoperative curative effect may be influenced by patients' duration of disease.