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文献转载 | 单通道非同轴内镜下颈椎后路椎间盘切除术联合纤维环缝合修复治疗 C6/C7 椎间盘突出症的病例报告
日期：2026-01-26 阅读：
Uniportal non-coaxial endoscopic posterior cervical discectomy with annular suture repair for C6/C7 disc herniation: a case report
单通道非同轴内镜下颈椎后路椎间盘切除术联合纤维环缝合修复治疗 C6/C7 椎间盘突出症的病例报告
Abstract
Background: Cervical disc herniation with radiculopathy is a common cause of neck and arm pain. While anterior cervical discectomy and fusion (ACDF) remains the standard treatment, it sacrifices motion and may cause adjacent segment degeneration. Uniportal non-coaxial spinal endoscopic surgery (UNSES) offers a motion-preserving alternative. This case presents the first application of UNSES with endoscopic annular suture repair and ligamentum flavum suspension in the cervical spine, demonstrating its technical feasibility.
Case presentation: A 54-year-old male presented with progressive neck and right right arm pain, numbness and triceps weakness, due to right paracentral C6/C7 disc herniation compressing the C7 nerve root. The patient underwent full-endoscopic posterior cervical discectomy using a uniportal non-coaxial endoscopic system, with ligamentum flavum preservation via suture suspension. The annular defect was repaired intraoperatively using an endoscopic annular suture device under direct visualization. Postoperative imaging confirmed complete neural decompression and successful annular closure without residual disc or dural compromise. Postoperative MRI confirmed complete decompression and annular closure. At 3 months, visual analog scale (VAS) improved from 7 to 1, the Japanese Orthopaedic Association (JOA) score increased from 13 to 16, and the Neck Disability Index (NDI) decreased from 42% to 14%, with no recurrence or instability.
Conclusions: UNSES combined with annular suture repair enables safe, motion-preserving decompression for cervical disc herniation. This novel approach may enhance biomechanical integrity, reduce recurrence, and represent a minimally invasive alternative to fusion in selected patients.
KEYWORDS
annular repair, cervical radiculopathy, endoscopic discectomy, ligamentum flavum preservation, minimally invasive spine surgery, non-coaxial endoscopy, uniportal spinal endoscopy
【摘要】
背景：伴神经根病的颈椎椎间盘突出症是颈肩臂痛的常见病因。尽管颈椎前路椎间盘切除融合术（ACDF）仍是标准治疗方案，但该术式会牺牲脊柱节段活动度，且可能导致邻近节段退变。单通道非同轴脊柱内镜手术（UNSES）为保留运动功能的治疗提供了新选择。本病例首次报道将 UNSES 联合内镜下纤维环缝合修复及黄韧带悬吊技术应用于颈椎，验证其技术可行性。
病例呈现：一名 54 岁男性患者，因 C6/C7 节段右侧旁中央型椎间盘突出压迫 C7 神经根，出现进行性颈痛、右上肢疼痛、麻木及肱三头肌无力症状。患者接受单通道非同轴内镜下颈椎后路椎间盘切除术，术中通过缝合悬吊保留黄韧带，并在直视下使用内镜专用纤维环缝合装置修复纤维环缺损。术后影像学检查证实神经完全减压，纤维环闭合良好，无残留椎间盘组织及硬脊膜损伤。术后 3 个月随访，视觉模拟评分（VAS）从 7 分降至 1 分，日本骨科协会（JOA）评分从 13 分提升至 16 分，颈椎功能障碍指数（NDI）从 42% 降至 14%，无复发及脊柱不稳表现。
结论：UNSES 联合纤维环缝合修复可安全、保留运动功能地解除颈椎椎间盘突出症的神经压迫。该新型术式有助于增强脊柱生物力学完整性、降低复发率，可为特定患者提供一种替代融合术的微创治疗方案。
关键词：纤维环修复；颈椎神经根病；内镜下椎间盘切除术；黄韧带保留；微创脊柱手术；非同轴内镜；单通道脊柱内镜
文章引用
Xiang Y, Zhang X, Sun F, Yang X, Hu X, Yang J, Ge W, Zhou T, Wang Y and Song E (2026) Uniportal non-coaxial endoscopic posterior cervical discectomy with annular suture repair for C6/C7 disc herniation: a case report.
Front. Surg. 12:1733374.
doi: 10.3389/fsurg.2025.1733374
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