关键词: 神经根型颈椎病； 颈椎前路椎间盘切除融合术； Delta大通道内镜； 疗效； 回顾性队列研究

Abstract: Objective To compare the efficacy of Delta large-channel endoscopic surgery versus anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on 75 patients with single-level CSR treated between April 2022 and May 2024,according to the surgical methods,they were divided into two groups.There were 32 cases in the Delta group,which underwent Delta large-channel endoscopic surgery.There were 43 cases in the ACDF group,and anterior cervical discectomy and fusion were performed.Perioperative indicators,visual analog scale (VAS),Japanese Orthopaedic Association (JOA) scores,and neck disability index (NDI) scores (preoperatively and at 3 days,3 months,and 12 months postoperatively) were compared.Radiographic parameters (preoperatively and 12 months postoperatively) and MacNab excellent-good rates at the final follow-up were also evaluated. Results The Delta group showed significantly less operative time[(62.34±7.35)min vs. (70.05±8.69)min],less intraoperative blood loss [(31.09±2.86)ml vs. (65.14±7.27) ml] and shorter hospital stay [(5.69±0.75)days vs. (9.44±1.80)days] than the ACDF group(all P<0.01).VAS,JOA,and NDI scores improved significantly at all postoperative time points in both groups (P<0.01).The VAS scores of the Delta group and the ACDF group at 3 days after surgery were (2.19±0.93) points and (2.88±0.79) points respectively,and at 3 months after surgery were (1.41±0.50) points and (2.12±0.79) points respectively.There was a statistically significant difference between the two groups (P<0.05).There was no statistically significant difference in VAS scores between the two groups at 12 months (P>0.05).No significant intergroup differences were found in JOA or NDI scores(P＞0.05) .The cervical curvature (Cobb Angle) of the ACDF group 12 months after the operation and before the operation was (18.54±0.28)° and (14.24±0.57)° respectively,and the intervertebral space height was (5.19±0.21)mm and (3.87±0.21)mm respectively.The range of motion of the adjacent segments of the upper segment was (10.06±0.90)° and (12.54±1.18)° respectively,and that of the adjacent segments of the lower segment was (8.67±0.94)° and (12.04±1.29) ° respectively.Compared with those before the operation,they increased,and the difference was statistically significant (P<0.05).There was no change in the Delta group (P>0.05).The excellent and good rates of MacNab in the two groups were 92.0% and 90.7% respectively,and there was no statistically significant difference between the two groups (P>0.05). Conclusion Delta large-channel endoscopic surgery is a safe and effective treatment for CSR,with clinical outcomes comparable to ACDF,while offering advantages in reduced intraoperative trauma and faster postoperative recovery.

Key words: cervical spondylotic radiculopathy; anterior cervical discectomy and fusion; Delta large-channel endoscopy; comparison of efficacy; retrospective cohort study