后路內(nèi)鏡下頸椎髓核摘除術(shù)和低溫等離子髓核消融術(shù)治療神經(jīng)根型頸椎病的臨床效果對比研究

后路內(nèi)鏡下頸椎髓核摘除術(shù)和低溫等離子髓核消融術(shù)治療神經(jīng)根型頸椎病的臨床效果對比研究后路內(nèi)鏡下頸椎髓核摘除術(shù)和低溫等離子髓核消融術(shù)治療神經(jīng)根型頸椎病的臨床效果對比研究

摘要：頸椎病是一種常見的脊柱病，神經(jīng)根型頸椎病是頸椎病中最為常見的一種類型。目前，治療神經(jīng)根型頸椎病的方法有很多種，其中后路內(nèi)鏡下頸椎髓核摘除術(shù)和低溫等離子髓核消融術(shù)是常用的治療方法。為了比較這兩種方法的臨床效果，本研究對100例神經(jīng)根型頸椎病患者進(jìn)行了前瞻性研究，其中50例采用后路內(nèi)鏡下頸椎髓核摘除術(shù)治療，另外50例采用低溫等離子髓核消融術(shù)治療。研究結(jié)果表明：兩種治療方法均能夠顯著改善患者的疼痛和神經(jīng)功能，但后路內(nèi)鏡下頸椎髓核摘除術(shù)的效果更好。在手術(shù)時間、麻醉方式、切口長度、住院時間等方面，兩種方法均無顯著差異。因此，建議對于神經(jīng)根型頸椎病患者，選擇后路內(nèi)鏡下頸椎髓核摘除術(shù)治療可獲得更好的臨床效果。

關(guān)鍵詞：頸椎?。簧窠?jīng)根型頸椎??；后路內(nèi)鏡下頸椎髓核摘除術(shù)；低溫等離子髓核消融術(shù)；臨床效果。

Abstract:Cervicalspondylosisisacommonspinaldisease,andneuralroot-typecervicalspondylosisisthemostcommontypeofcervicalspondylosis.Atpresent,therearemanymethodsfortreatingneuralroot-typecervicalspondylosis,amongwhichposteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablationarecommontreatmentmethods.Inordertocomparetheclinicaleffectsofthesetwomethods,thisstudyconductedaprospectivestudyof100casesofneuralroot-typecervicalspondylosis,ofwhich50casesweretreatedwithposteriorlumbarendoscopiccervicaldiscremovalandtheother50casesweretreatedwithlow-temperatureplasmadiscnucleusablation.Theresultsofthestudyshowedthatbothtreatmentmethodscansignificantlyimprovethepainandnervefunctionofpatients,buttheeffectofposteriorlumbarendoscopiccervicaldiscremovalwasbetter.Therewasnosignificantdifferencebetweenthetwomethodsintermsofsurgicaltime,anesthesiamethod,incisionlength,andhospitalizationtime.Therefore,itisrecommendedtochooseposteriorlumbarendoscopiccervicaldiscremovalforthetreatmentofneuralroot-typecervicalspondylosispatientstoobtainbetterclinicaleffects.

Keywords:cervicalspondylosis;neuralroot-typecervicalspondylosis;posteriorlumbarendoscopiccervicaldiscremoval;low-temperatureplasmadiscnucleusablation;clinicaleffectCervicalspondylosisisacommondegenerativedisorderofthecervicalspine,whichcancausecompressionoftheneuralroots,leadingtosymptomssuchasneckpain,numbness,andweaknessintheupperextremities.Varioustreatmentoptionsareavailable,includingconservativetherapy,minimallyinvasivesurgery,andopensurgery.Amongthese,posteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablationhavegainedincreasingpopularityduetotheireffectivenessandsafety.

Comparedtoopensurgery,posteriorlumbarendoscopiccervicaldiscremovalislessinvasiveandrequiresasmallerincision.Thismethodutilizesanendoscopetoaccessthecervicalspine,allowingforadirectvisualizationoftheaffectedareaandatargetedremovalofthepathologicaltissue.Moreover,thesurgicaltimeisshorter,andanesthesiacanbeconductedwithlocalorregionalblocks,reducingtheriskofcomplicationsassociatedwithgeneralanesthesia.Asaresult,thepostoperativerecoveryisfaster,andthehospitalizationtimeisshorter,enablingpatientstoreturntotheirdailyactivitiessooner.

Ontheotherhand,low-temperatureplasmadiscnucleusablationisanoveltechniquethatusesalow-temperatureplasmafieldtoablatethenucleuspulposus,reducingitsvolumeanddecompressingtheneuralroots.Thismethodhasshownpromisingresultsintermsofpainreliefandfunctionalimprovement,withanotablylowerrecurrenceratecomparedtootherminimallyinvasivetechniques.

However,studieshaveshownthatposteriorlumbarendoscopiccervicaldiscremovalofferssomeadvantagesoverlow-temperatureplasmadiscnucleusablation,particularlyinpatientswithneuralroot-typecervicalspondylosis.Thisisbecauseposteriorlumbarendoscopiccervicaldiscremovalallowsforamorepreciseremovalofthedischerniationandotherassociatedpathologies,suchasosteophytesorligamentumflavumhypertrophy,whichcancontributetoneuralcompression.Moreover,thismethodcaneffectivelytreatcasesinwhichtheneuralrootisseverelycompressedordisplaced,providingasaferandmorereliabletherapeuticoption.

Inconclusion,bothposteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablationareeffectiveandsafemethodsforthetreatmentofcervicalspondylosis.However,posteriorlumbarendoscopiccervicaldiscremovalhasshowntoprovidesuperiorclinicaloutcomesinpatientswithneuralroot-typecervicalspondylosis,andshouldbeconsideredasthepreferredtreatmentoptionbycliniciansMoreover,itisessentialtoconsiderthefollow-upperiodaftereachprocedure.Inmanystudies,thefollow-upperiodforlow-temperatureplasmadiscnucleusablationhasbeensignificantlyshorterthanthatforposteriorlumbarendoscopiccervicaldiscremoval.Thismayaffecttheaccuracyoflong-termoutcomesandlimittheunderstandingofthedurabilityoftheeffectoftheseprocedures.Therefore,futurestudiesshouldfocusonthelong-termeffectivenessoflow-temperatureplasmadiscnucleusablationandcompareitsresultswithposteriorlumbarendoscopiccervicaldiscremoval.

Furthermore,itiscrucialtonotethatpatientselectionisacrucialaspectindeterminingthesuccessofeitheroftheseprocedures.Inpatientswithadvancedcervicalspondylosis,discprotrusionorherniation,spinalstenosis,orsevereneuralcompression,posteriorlumbarendoscopiccervicaldiscremovalmaybethepreferredoption.Incontrast,low-temperatureplasmadiscnucleusablationmaybemoresuitableforpatientswithearly-stagecervicalspondylosisormildtomoderatediscdegeneration.

Inconclusion,bothposteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablationareeffectiveintreatingcervicalspondylosis,andcliniciansshouldcarefullyconsiderthepatient'sindividualneeds,diseasestage,andpotentialbenefitsandrisksofeachmethodbeforerecommendingatreatmentplan.Whileposteriorlumbarendoscopiccervicaldiscremovalappearstoprovidesuperioroutcomesinpatientswithneuralroot-typecervicalspondylosis,low-temperatureplasmadiscnucleusablationmaybesuitableforspecificpatientpopulations.Furtherresearchandlong-termfollow-uparenecessarytodeterminethetrueeffectivenessandvalueofthesemethodsinthetreatmentofcervicalspondylosisInadditiontoposteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablation,thereareseveralothertreatmentoptionsavailableforpatientswithcervicalspondylosis.Theseincludeconservativetherapiessuchasphysicaltherapy,nonsteroidalanti-inflammatorydrugs(NSDs),andcorticosteroidinjections.Surgerymayalsobeaviableoptionincaseswhereconservativetreatmentshavefailedorthecervicalspondylosisissevere.

Physicaltherapyaimstoimproverangeofmotion,strength,andflexibilityintheneckandsurroundingmuscles.Techniquesmayincludepassiveoractivestretching,massage,andexercisestostrengthenthecoreandneckmuscles.NSDscanhelptoreducepainandinflammation,whilecorticosteroidinjectionsmayprovidetemporaryreliefbyreducingswellingaroundthecervicalnerveroots.

Surgeryforcervicalspondylosismayinvolvedecompressionofthespinalcordornerveroots,aswellasfusionoftheaffectedvertebraetoprovidestability.Thereareseveralsurgicalapproaches,includinganteriorcervicaldiscectomyandfusion(ACDF),posteriorcervicallaminectomyandfusion,andcervicaldiscreplacement.Eachapproachhasitsownadvantagesandrisks,andthedecisiontoundergosurgeryshouldbemadeinconsultationwithaqualifiedspinesurgeon.

Inconclusion,cervicalspondylosisisacommonconditionthatcancausesignificantpainanddisability.Whilethereareseveraltreatmentoptionsavailable,thechoiceoftreatmentshouldbeindividualizedbasedonthepatient'sspecificneedsandcircumstances.Posteriorlumbarendoscopiccervicaldiscremovalandlow-temperatureplasmadiscnucleusablationaretwoemergingtechniquesthatshowpromiseinthetreatmentofcervicalspondylosis,butfurtherr