| Objective:To compare the clinical efficacy of large-channel and dual-channel spinal endoscopy in the treatment of radiculotic cervical spondylosis,summarize the characteristics of different surgical procedures and instruments of the two technologies,and discuss their respective advantages and disadvantages,so as to provide effective evidence support for the clinical development of the two technologies.Methods:Retrospective analysis was performed on 53 patients with radicular cervical spondylosis who underwent cervical endoscopy through posterior cervical approach in 1stDepartment of Neck,Shoulder,Lumbar and Leg Pain about Sichuan Orthopedic Hospital from October 1,2020 to March 20,2022.Among them,3 cases were lost to follow-up and a total of 50 cases were included,who were randomly divided into 2 groups according to different surgical methods.A total of25 patients receiving Delta endoscopic treatment through large channel were referred to as the large channel group.A total of 25 patients underwent Ube dual-channel endoscopic therapy,which was referred to as the dual-channel group.Firstly,preoperative clinical data,operation time,intraoperative blood loss,postoperative hospital stay and postoperative complications of the two groups were compared and analyzed.Then,the visual analog scale（VAS）and neck disability index（NDI）scores in pre-operation on 2 hours,1 week,1 month,3 months,6months,1 year after operation were compared and analyzed.At the same time,Nakamu-ra method was used to calculate the side block removal rate and comparative analysis.Finally,the clinical efficacy at the last follow-up was evaluated by using the modified Odom’s grading evaluation method,and the excellent and good rate of clinical efficacy was calculated,and the technical points were summarized.Results:All patients in both groups successfully completed the operation.The operation time in the large channel group was shorter than that in the double channel group,and the difference was statistically significant（p<0.05）;The intraoperative blood loss in the large channel group was significantly less than that in the double channel group,and the difference was statistically significant（p<0.05）;There were no significant differences in age,gender,preoperative basic data,postoperative lateral mass clearance rate,postoperative hospital stay,and postoperative complications between the two groups（p>0.05）.In this study group,the incidence of postoperative complication rate was 4%in the dual-channel group and 0%in the large-channel group.Compared with preoperative treatment,the cervical and shoulder VAS scores,upper limb VAS scores and cervical NDI scores were significantly improved in both groups,and there was a significant difference in the cervical and shoulder VAS scores 1 week after surgery between the two groups,that is,the large channel group was significantly lower than the double channel group,the difference was statistically significant（p<0.05）,but at other time points between the two groups,there was no significant difference between the NDI scores of cervical spine and the VAS scores of neck,shoulder and upper limbs（p>0.05）.There was no significant difference between the two groups in the excellent and good rate of the last follow-up（p>0.05）.Conclusion:Minimally invasive spinal technique for the treatment of radiculotic cervical spondylosis has good safety and efficacy,and this technique is worth popularizing.Compared with dual-channel treatment for single-level radiculotic spondylosis,the large channel treatment has shorter operation time and less blood loss,and is more efficient for nerve root decompression. |
