Clinical Analysis Of Endoscopic Posterior Cervical Foraminotomy In The Treatment Of Crvical Spondylotic Radiculopathy

Background:Althoughanterior cervical discectomy and fusion are still the main surgical methods for treatment of crvical spondylotic radiculopathy,their accelerated postoperative degeneration of adjacent vertebral bodies,loss of intervertebral height,and incomplete fusion of bone graft Occurrence of complications such as the formation of pseudoarticular joints.With the continuous advancement of spinal imaging technology and the continuous development of minimally invasive surgery and the combination of the two,the endoscopic posterior cervical foraminotomy based on spine endoscopy and posterior foraminoplasty decompression has gradually matured,and the use of this technique can reduce the occurrence of postoperative complications while achieving the same decompression effect as the traditional open surgery.Objective:Explore the clinical efficacy of endoscopic posterior cervical foraminotomy in the treatment of crvical spondylotic radiculopathy.Methods:Retrospective analysis of 30 patients with cervical spondylotic myelopathy treated with endoscopic posterior cervical foraminotomy from April 2015 to December 16 in our hospital,including male 17 Cases,13 women,aged 36-65 years old,mean age 47.2 years old,all patients with single-segment cervical spondylotic root disease.The lesion segment was responsible for 8 cases of C4-5,17 cases of C5-6,and 5 cases of C6-7.Before and 2 days,1 month,3 months,6 months and 1 year after operation,the visual analogue scale(VAS)was used to evaluate the degree of pain in the neck,shoulders,and upper extremities.The Japanese Orthopaedic Association(JOA)cervical spondylotic myelopathy score was used to assess neurological function.Measurement of horizontal displacement and vertebral angular displacement of adjacent vertebral bodies by means of cervical vertebral dynamics,intervertebral angle >10°or displacement >3 mm was judged as cervical intervertebral instability.Postoperatively,patients’ quality of life was assessed using the modified MacNab standard and statistical analysis was performed.Results:All patients successfully completed the surgery.No spinal cord and nerve root injury occurred during the operation.The patients’ nerve root symptoms were effectively relieved at discharge.The VAS scores at 2 days,1 month,3 months,6 months,and 1 year after surgery were(2.33±0.99),(2.17±0.78),and(2.21±0.81,respectively).),(2.02±0.87),(1.80±0.98),statistically significant(P less than 0.05)compared with preoperative score(6.42±1.36),JOA scores(16.35±0.48),(16.03±0.76),(15.64±0.52),(16.01±0.62),(15.83±0.47)were statistically significant compared with the preoperative JOA score(12.58±1.54)(P less than 0.05).One year after the operation,the modified MacNab standard had excellent clinical results in 23 cases and good in 7 cases.No significant cervical spine instability was found after reviewing the cervical spine.Conclusion:Endoscopic posterior cervical foraminotomy for the treatment of crvical spondylotic radiculopathy is safe and feasible.The curative effect in the short term is definite and it is worth popularizing and applying.