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  • Title: Clinical observation of ultrasound-guided acupotomy assisting percutaneous cervical disc nucleoplasty in the treatment of cervical spondylotic radiculopathy.
    Author: Yao ZY, Fan SY.
    Journal: Zhen Ci Yan Jiu; 2024 Jun 25; 49(6):604-610. PubMed ID: 38897804.
    Abstract:
    OBJECTIVES: To observe the clinical efficacy and safety of ultrasound-guided acupotomy in adjuvant treatment of residual symptoms after percutaneous cervical disc nucleoplasty (PCDN) for cervical spondylotic radiculopathy (CSR). METHODS: A total of 70 CSR patients were divided into treatment group and control group according to random number table, with 35 cases in each group. Patients in the control group received PCDN, while patients in the treatment group further received ultrasound-guided acupotomy, which was performed once every 5 to 7 days for a total of 4 to 6 times (adjusted according to the condition of patients). The visual analog score (VAS), neck dysfunction index (NDI), Japanese Orthopaedic Association cervical spondylosis scale (JOA score), and Tanaka Yasuhisa 20-point scale were adopted in the assessment before PCDN and 1 day, 1 month, 3 months, 6 months after PCDN. The clinical efficacy, postoperative adverse reactions and complications of the 2 groups were evaluated. RESULTS: Compared with those before PCDN, the VAS score and NDI score of the 2 groups were decreased (P<0.05), JOA score and Tanaka Yasuhisa 20-point score were increased (P<0.05) at 1 day and 1, 3 and 6 months after surgery. Compared with same group 1 day after surgery, the VAS score and NDI score of the treatment group were decreased (P<0.05), while JOA score and Tanaka Yasuhisa 20-point score were increased (P<0.05) at 1, 3 and 6 months after surgery. Compared with the control group at the same time points, the VAS score and NDI score of the treatment group were decreased (P<0.05), while JOA score and Tanaka Yasuhisa 20-point score were increased (P<0.05) at 1, 3 and 6 months after operation. The effective rate and excellent rate of the treatment group 1, 3 and 6 months after PCDN were higher than those of the control group (P<0.05). Follow-up to 1 year after surgery, no significant postoperative adverse reactions and complications were found in both groups. CONCLUSIONS: Ultrasound-guided acupotomy can significantly improve the residual symptoms after PCDN for CSR patients, and the clinical efficacy is significantly better than that of PCDN alone, and this therapy is safe and reliable. 目的: 观察超声引导下针刀疗法辅助治疗神经根型颈椎病低温等离子髓核射频消融术（PCDN）术后残留症状的疗效及安全性。方法: 将70例神经根型颈椎病患者随机分为试验组和对照组，每组35例。对照组患者接受PCDN治疗。试验组患者在对照组基础上在PCDN术后第2天行超声引导下针刀治疗，每隔5~7 d进行1次，共行4~6次。分别于PCDN术前和术后1 d（针刀治疗前）及1、3、6个月时采用疼痛视觉模拟量尺（VAS）评分评价患者疼痛程度，采用颈部功能障碍指数（NDI）评分、日本骨科学会颈椎病（JOA）评分、田中靖久20分法量表评估患者颈椎病的严重程度，评估两组患者的临床疗效并计算治疗有效率和优良率，记录术后不良反应及并发症。结果: 与PCDN术前比较，术后1 d及1、3、6个月时两组患者的VAS评分和NDI评分均降低（P<0.05），JOA评分和田中靖久20分法评分均升高（P<0.05）。与术后1 d比较，试验组患者术后1、3、6个月时VAS评分和NDI评分均降低（P<0.05），JOA评分和田中靖久20分法评分均升高（P<0.05）。与同时点对照组比较，试验组术后1、3、6个月时VAS评分和NDI评分均降低（P<0.05），JOA评分和田中靖久20分法评分均升高（P<0.05）。试验组患者PCDN术后1、3、6个月时有效率和优良率均高于同时间点对照组（P<0.05）。随访至术后1年，两组患者均无明显术后不良反应及并发症。结论: 超声引导下针刀疗法可显著改善神经根型颈椎病PCDN后的残留症状，疗效明显优于单纯行PCDN手术，且安全可靠。.
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