Table1_Clinical effect of channel assisted cervical key hole technology combined with ultrasonic bone osteotome in the treatment of single segment cervical spondylotic radiculopathy.docx

ObjectiveTo explore the clinical effect and operating skills of channel assisted Cervical Key Hole technology combined with Ultrasonic Bone Osteotome (CKH-UBO) in the treatment of single segment cervical spondylotic radiculopathy (CSR).
MethodsFrom June 2018 to June 2020, 14 patients diagnosed with CSR and treated with channel assisted CKH-UBO were collected. The duration of the disease, the length of the incision, the operation time, the amount of bleeding during the operation, the length of hospitalization and the complications were recorded. The Range Of Motion (ROM) and the stability of the surgical segment were recorded before and after the operation. Visual analog scale (VAS), neck disability index (NDI) and modified macnab efficacy evaluation criteria were used to evaluate the surgical efficacy.
ResultsThe operative segments of the enrolled patients were all lower cervical vertebrae. The average incision length was 2.0 ± 0.1 cm, the operation time was 42.2 ± 5.7 min, the intraoperative bleeding volume was 32.7 ± 4.1 ml, and the hospital stay was 5.6 ± 1.2 days. There was no difference in ROM between preoperative and 3 months and 1 year after operation (P > 0.05), and all patients did not have segmental instability. The VAS scores of neck pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 5.6 ± 1.2, 1.6 ± 0.6, 1.1 ± 0.7, 0.6 ± 0.5, and the VAS scores of upper limb pain were 6.2 ± 1.2, 1.7 ± 0.7, 1.1 ± 0.6, 0.6 ± 0.5. The NDI scores of upper limb pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 36.7 ± 3.5, 9.8 ± 2.4, and 3.9 ± 1.5, 1.8 ± 1.0, The VAS and NDI scores at all follow-up time points after operation were significantly lower than those before operation (P < 0.001). One year after operation, the curative effect was evaluated according to the modified macnab evaluation standard, and the excellent and good rate was 100%. The complication rate was 6.25%.
ConclusionChannel assisted CKH-UBO for single segment CSR has the advantages of short operation time, reliable clinical effect, high safety and low complication rate, which is worthy of clinical promotion.

目的 探讨通道辅助颈椎钥匙孔技术（channel assisted Cervical Key Hole technology）联合超声骨刀（Ultrasonic Bone Osteotome，CKH-UBO）治疗单节段神经根型颈椎病（cervical spondylotic radiculopathy，CSR）的临床疗效与操作技巧。
方法 收集2018年6月至2020年6月收治的14例采用通道辅助CKH-UBO治疗的CSR患者临床资料。记录患者病程、切口长度、手术时长、术中出血量、住院时长及并发症发生情况；分别于术前及术后记录手术节段的活动度（Range Of Motion，ROM）与稳定性。采用视觉模拟评分法（Visual Analog Scale，VAS）、颈椎功能障碍指数（Neck Disability Index，NDI）及改良Macnab疗效评价标准评估手术疗效。
结果 纳入患者的手术节段均为下颈椎。患者平均切口长度为2.0±0.1 cm，手术时长为42.2±5.7 min，术中出血量为32.7±4.1 ml，住院时长为5.6±1.2天。术前、术后3个月及术后1年的手术节段ROM差异无统计学意义（P>0.05），所有患者均未出现节段性不稳定。术前、术后3天、术后3个月及术后1年的颈部VAS评分分别为5.6±1.2、1.6±0.6、1.1±0.7、0.6±0.5；上肢疼痛VAS评分分别为6.2±1.2、1.7±0.7、1.1±0.6、0.6±0.5。术前、术后3天、术后3个月及术后1年的NDI评分分别为36.7±3.5、9.8±2.4、3.9±1.5、1.8±1.0；术后各随访时间点的VAS及NDI评分均显著低于术前（P<0.001）。术后1年采用改良Macnab评价标准评估疗效，优良率为100%，并发症发生率为6.25%。
结论 通道辅助CKH-UBO治疗单节段CSR具有手术时长较短、临床疗效确切、安全性高、并发症发生率低的优势，值得临床推广应用。