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多节段脊髓型颈椎病的诊断和外科治疗

Diagnosis and Surgical Therapy of Multi-segmental Cervical Spondylotic Myelopathy

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【作者】 曹永飞张美心

【Author】 CAO Yong-fei1,ZHANG Mei-xin2.(1.Department of Orthopedics,Inner Mongolia Hospital,Huhhot 010020,China; 2.Department of Orthopedics,People′s Hospital of Guizhou Province,Guiyang 550002,China)

【机构】 内蒙古医院骨科贵州省人民医院骨科 呼和浩特010020贵阳550002

【摘要】 探讨治疗多节段脊髓型颈椎病的手术方式及疗效。颈椎病的发病是神经、血管的压迫与相应节段的不稳定2个因素共同作用的结果。手术时机、病理变化程度及手术技术等对治疗效果有明显影响,准确诊断早期减压是提高疗效的主要措施。病变≤2个间隙时,应选择前路手术;病变≥3个间隙的病例,日本骨科学会下腰痛评价表评分改善率后路手术大于前路手术;对于发育性颈椎管狭窄合并脊髓型颈椎病前路、后路各种术式有着各自不同的适应证,选择合理的治疗手段十分重要。

【Abstract】 To explore the surgical techniques of treatment for multi-segmental cervical spondylotic myelopathy and related effects.Cervical spondylosis results from coaction of two factors including neuro-vascular compression and instability of corresponding segments.Operative time,pathological changes,surgery supports and so on have obvious influence on its therapeutic outcome.Correct diagnosis and earlier decompression are the main measures to improve its therapeutic effects.Anterior approach is recommended in patients with less than two involved segments.For patients with more than 3 involved segments,posterior approach has higher improvement rate than that of anterior approach according to the score in evaluation table of lower back pain of JOA.As for patients with developing cervical spinal stenosis combined with cervical spondylotic myelopathy,posterior approach and anterior approach have their own indication,of which the feasible selection is very important.

  • 【文献出处】 医学综述 ,Medical Recapitulate , 编辑部邮箱 ,2007年17期
  • 【分类号】R687.3
  • 【被引频次】8
  • 【下载频次】188
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