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find Author "荣雪芹" 2 results
  • 经皮内镜下病灶清除与药物灌洗治疗脊柱结核

    目的总结经皮内镜下病灶清除与药物灌洗治疗脊柱结核的临床疗效。方法回顾分析 2018 年 1 月—2019 年 12 月采用经皮内镜下病灶清除与药物灌洗治疗的 25 例脊柱结核患者临床资料。其中男 18 例,女 7 例;年龄 29~85 岁,平均 59.4 岁。病程 1~120 个月,中位时间 17.5 个月。结合手术前后患者红细胞沉降率(erythrocyte sedimentation rate,ESR)、C 反应蛋白(C reactive protein,CRP)、疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、神经功能美国脊髓损伤协会(ASIA)分级及影像学资料,综合评估患者术后功能恢复和脊柱结核治愈情况。结果所有患者顺利完成手术,手术时间(103.5±33.9)min,术中出血量(27.5±17.5)mL。术后切口均 Ⅰ 期愈合。25 例均获随访,随访时间 12~22 个月,平均 15 个月。末次随访时 ESR、CRP 及 VAS 评分、ODI 均较术前显著改善(P<0.05);ASIA 分级除 1 例 D 级外,其余 24 例均为 E 级;CT 及 MRI 示椎体病灶愈合良好,未见明显塌陷,无结核复发。结论经皮内镜下病灶清除与药物灌洗是一种治疗脊柱结核较为安全、有效、微创的方式。

    Release date:2021-06-07 02:00 Export PDF Favorites Scan
  • Clinical study of single-level cervical disc herniation treated by full-endoscopic decompression via anterior transcorporeal approach

    ObjectiveTo investigate the clinical feasibility of full-endoscopic decompression for the treatment of single-level cervical disc herniation via anterior transcorporeal approach.MethodsAccording to the inclusion and exclusion criteria, 21 patients with cervical disc herniation who received full-endoscopic decompression via anterior transcorporeal approach between September 2014 and March 2016 were retrospectively analyzed. There were 12 males and 9 females with an age ranged from 32 to 65 years, with an average of 48.5 years. The duration of symptoms ranged from 6 to 18 weeks, with an average of 10.5 weeks. According to the Nurick grading of spinal cord symptoms, there were 2 cases with grade 1, 7 cases with grade 2, and 12 cases with grade 3. Operative segment was C3, 4 in 2 cases, C4, 5 in 8 cases, C5, 6 in 9 cases, and C6, 7 in 2 cases. The operation time and related complications were recorded. The central vertical height of the vertebral body and the diseased segment space were measured on the cervical X-ray film. The neck and shoulder pain were evaluated by visual analogue scale (VAS) score; Japanese Orthopaedic Association (JOA) score was used to evaluate the improvement of neurological function in patients. The MRI of cervical spine was reexamined at 3 months after operation, and the CT of cervical spine was reexamined at 12 months after operation. The decompression of spinal cord and the healing of bone canal in the vertebral body were further evaluated.ResultsFull-endoscopic decompression via anterior transcorporeal approach were achieved at all 21 patients. The operation time was 85-135 minutes, with an average of 96.5 minutes. All patients were followed up 24-27 months, with an average of 24.5 months. There was no complication such as residual nucleus pulposus, spinal cord injury, large esophageal vessels injury, pleural effusion, endplate collapse, intraspinal hematoma, cervical spine instability, protrusion of disc in the same segment, or kyphosis. Both VAS scores of neck and shoulder pain and JOA scores were significantly improved at 12 months after operation (P<0.05). At 3 months after operation, it was confirmed by the cervical MRI that neural decompression was sufficient and the abnormal signal was also degraded in the patients with intramedullary high signal at T2-weighted image. The cervical CT showed that bone healing were achieved in the surgical vertebral bodies of all patients at 12 months after operation. At 24 months after operation, the central vertical height of the diseased segment space significantly decreased compared with preoperative one (t=2.043, P=0.035); but there was no significant difference in the central vertical height of the vertebral body between pre- and post-operation (t=0.881, P=0.421).ConclusionFull-endoscopic decompression via anterior transcorporeal approach, integrating the advantages of the endoscopic surgery and the transcorporeal approach, provide an ideal and thorough decompression of the ventral spinal cord with satisfactory clinical and radiographic results.

    Release date:2020-06-15 02:43 Export PDF Favorites Scan
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