关键词: 颈椎病, 低温等离子髓核消融术, 治疗结果

Abstract: Objective To comparatively evaluate the clinical effectiveness of percutaneous coblation nucleoplasty (PCN) versus medication and physical therapy for cervical spondylotic radiculopathy (CSR), so as to provide clinical evidence to optimize treatment strategies. 
Methods A total of 176 patients diagnosed with CSR from December 2019 to December 2022  in Department of Spinal Surgery, Handan Central Hospital, Hebei Province, were retrospectively analyzed and divided into three groups: medication group (n=51), physical therapy group (n=57), and PCN group (n=68). The medication group received intravenous mannitol, dexamethasone, and neurotropin for 14 d, the physical therapy group underwent cervical traction for 14 d, and the PCN group underwent PCN. The course of treatment for medication group and physical therapy group was 14 d, and PCN group received PCN guided by C-arm fluoroscopy. Visual analogue scale (VAS) score, neck disability index (NDI), Northwick Park Neck Pain Questionnaire (NPQ), and Yasuhisa Tanaka 20 score scale (YT20) scores were recorded before treatment and at 1 d, 2 weeks, 3 months, and 6 months after treatment. The modified Macnab criteria were used to assess overall therapeutic effectiveness at 3 months after treatment. 
Results All the three groups showed significant improvement in VAS, NDI, and NPQ scores (decreasing trends), and YT20 scores (increasing trends) over time. The PCN group exhibited superior outcomes compared with the medication and physical therapy groups, demonstrated by significantly lower VAS, NDI, and NPQ scores and higher YT20 scores. Significant differences were observed in the interaction between groups, time points, and time points between groups (Fbetween groups=5.790, 72.607, 21.753, 21.416; Ftime points=753.315, 2 345.915, 2 549.043, 755.616; Ftime points between groups=4.276, 133.825, 20.694, 19.612; all P＜0.05). At 3 months after treatment, the PCN group achieved a higher overall response rate (92.65%) compared with the medication group (47.06%) and physical therapy group (54.39%), showing significant differences (P＜0.05). 
Conclusion PCN significantly improves the symptoms of CSR, including neck pain, upper limb pain, numbness, daily work and quality of life, demonstrating substantial clinical effectiveness and promoting better cervical spine function, which is, therefore, worthy of clinical recommendation. 

Key words: cervical spondylosis, percutaneous coblation nucleoplasty, treatment outcome