摘要
目的 评价经皮颈椎间盘切除术 (PCD)和化学溶核 (CNL)治疗颈椎间盘突出症的价值。资料与方法 6 6例颈椎间盘突出症患者行PCD和CNL术。男 39例 ,女 2 7例 ,年龄 35～ 6 0岁 ,平均 5 3岁。 6 6例中 ,2 6例为脊髓型 ,9例为神经根型 ,3例为椎动脉型 ,2 8例为混合型。穿刺点位于气管与颈部血管之间 ,在C形臂透视引导下 ,将引导针、扩张管、切吸器插入病变间盘。当无髓核切吸出时拔出切吸器 ,经扩张管注入胶原酶 6 0 0U。结果 6 6例中 ,优 31例 ,良 2 9例 ,差 6例。 2例有颈部出血和 1例有眼部“黑蒙” ,余患者无其他严重并发症。结论 PCD +CNL是一种微创、安全的介入方法。原理同腰椎间盘切吸术和溶核一样 ,主要是切除和溶解髓核 ,降低间盘内压力 ,减少对脊髓、神经根的压迫与刺激 。
Objective To evaluate percutaneous cervical diskectomy (PCD) and chemonucleolysis (CNL) in treating cervical disk herniation.Materials and Methods PCD and CNL were performed in 66 patients with cervical disk herniation. The patients included 39 males and 27 females, with the age of 35～60 years (mean 53). Of the total 66 cases, myelopathic type was seen in 26, radiculopathic type in 9, vertebroarterial type in 3 and mixed type in 28. The puncture point was between the trachea and carotid vessels. Under C-arm fluoroscopic monitoring, the guide-needle, dilator and cutting aspirator were inserted into the diseased disk space. The cutting apparatus was removed when no more nucleus tissue could be aspirated. Then 600U collagenase was injected into the disk space through the dilator. Results Excellent results were obtained in 31, good results in 29 and poor results in 6 cases. Except for local bleeding of the neck occurring in 2 cases and transient “amaurosis” in one case, no other serious complications occurred.Conclusion PCD with CNL is a minimally-invasive and safe interventional technique. It carries the same principles as the lumbar diskectomy and chemonucleolysis. It can clear or relive the neurological symptoms through removing and lysing the herniated nucleus and, thus, reducing the pressure on the spinal cord and nerve root.
出处
《临床放射学杂志》
CSCD
北大核心
2004年第4期340-343,共4页
Journal of Clinical Radiology
关键词
经皮颈椎间盘切除
溶核
治疗
颈椎间盘突出症
Percutaneous cervical diskectomy Chemonucleolysis Cervical disk herniation Interventional radiology
