摘要
目的探讨脊髓型颈椎病(cervicalspondyloticmyelopathy,CSM)患者椎间隙狭窄程度与颈椎不稳和脊髓压迫部位的关系及其对术式选择的意义。方法回顾性分析35例伴有椎间隙明显狭窄的CSM患者的动态X线和MRI表现,观察颈椎不稳和脊髓压迫部位与狭窄椎间隙的关系,并与同期75例椎间隙接近正常的CSM患者比较。结果伴有椎间隙明显狭窄的CSM患者组中,25例狭窄椎间隙上方的邻近椎体出现不稳(71.4%),21例上方邻近椎间盘明显退变(60%)。椎间隙接近正常的CSM患者组,17例存在节段性颈椎不稳(22.7%)。结论CSM患者明显狭窄椎间隙的上方邻近椎体有失稳倾向,上方邻近椎间盘有加速退变的趋势。手术时应注意对邻近节段的处理。
Objective:To investigate the relationship between obviously narrowed intervertebral space and cervical instability or spinal cord compression in cervical spondylotic myelopathy(CSM) and to discuss its significance for the choice of operation.Method:The dynamic radiographs and MRI of 35 patients of CSM with obviously narrowed intervertebral space were reviewed retrospectively.Factors of cervical instability and spinal cord compression were analyzed.75 cases of CSM with normal intervertebral space were analyzed for comparison.Result:In CSM with obviously narrowed intervertebral space, cervical instability of upper adjacent vertebra was found in 25 cases(71.4%) and degeneration of upper adjacent discs was found in 21 cases(60%).In CSM with normal intervertebral space, cervical instability was found in 17 cases(22.7%).Conclusion:The upper adjacent vertebra above the obviously narrowed intervertebral space has the tendency of instability and the upper adjacent disc has the inclination of accelerated degeneration.Multisegmental anterior cervical decompression and fusion with plate or posterior laminoplasty should be used for operative treatment.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2004年第9期524-526,共3页
Chinese Journal of Spine and Spinal Cord
关键词
脊髓型颈椎病
椎间隙狭窄程度
颈椎不稳
动态X线
MRI
脊髓乐迫
Intervertebral spac narrow
Cervical spondylotic myelopathy
Cervical instability
Spinal cord compression
