Evaluation Of The Efficacy Of The Full-endoscopy Nerve Root Canal Decompression In The Treatment Of Cervical Nerve Root Canal Stenosis

Objective:To evaluate the effectiveness of full-endoscopic nerve root canal decompression in the treatment of cervical nerve root canal stenosis.Methods:From October 2015 to October 2018,30 patients with cervical spinal nerve root canal stenosis who met the selection criteria were included in the study.There were 13 males and 17 females,with an average age of 47.67 ± 9.75 years(range 33-74 years).The diameter of the compressed nerve root was measured before the MRI cross-section of the cervical spine.The area where the diameter of the cervical nerve root canal was smaller than the diameter of the nerve root was regarded as a stenosis.With the compressed nerve root as the reference,the patient’s neck was measured at the CT cross-section of the cervical nerve root canal The length of nerve root canal stenosis.All patients under went full-endoscopic nerve root canal decompression.Review CT after operation and measure the length of decompression zone.The pain visual analogue score(VAS)was used to evaluate the pain relief of the upper limbs and neck of the patients during the follow-up before,2 days,3 months,6months and 12 months postoperatively.The cervical spine dysfunction index(NDI)assesses the improvement of patients’ symptoms and signs.At the last follow-up,the excellent rate was evaluated using the modified Macnab score.Result: The length of cervical nerve root canal stenosis was 2.2-8.5mm,with an average of 5.46±1.82 mm.The preoperative VAS score and NDI score were 7.00 ±0.95 and 45.13 ±13.66,respectively.All patients successfully completed the operation.The operation time was 45-200 minutes,with an average of 93.83±34.86 minutes.No significant bleeding was seen during the operation.The length of the decompression zone is 3.7-12.9 mm,with an average of 7.44±2.19 mm.Postoperative pain and numbness were significantly relieved.All 30 patients were followed for at least 12 months.The patient’s VAS score was 2.83 ± 0.70 on the 2nd day after operation,1.6 ±0.50 on the 3rd month after operation,1.23 ± 0.43 on the 6th month after operation,and 1.07 ± 0.25 on the 12 th month after operation.The NDI score was 11.13 ± 3.14 on the 2nd day after operation,6.27 ± 1.80 on the 3rd month after operation,3.53 ±1.14 on the 6th month after operation,and 2.47 ± 0.86 on the 12 th month after operation.The difference was statistically significant(P <0.05).At the last follow-up,Macnab evaluated clinical efficacy.24 cases were excellent,4 cases were good,and 2cases were fair.The excellent and good rate was 93.3%.Conclusion:The Full-endoscopic decompression of cervical nerve root canal incision is feasible and effective for the treatment of cervical spondylotic radiculopathy caused by bone stenosis of cervical nerve root canal.The measurement methods in the study provide a scientific method for the minimally invasive individualized treatment of cervical root canal stenosis.