脊髓型颈椎病的早期诊断和手术时机

Cervical spondylotic myelopathy:early diagnosis and timing of operation

目的探讨脊髓型颈椎病早期诊断和外科手术时机。方法报告并讨论７４例脊髓型颈椎病患者早期诊断，并经颈前路减压、自体髂骨融合术的临床表现、治疗方法及结果等。结果脊髓型颈椎病早期起病隐匿，颈部痛觉轻微，以肢体运动和感觉异常及手臂症状最为常见，检查时可发现神经功能的改变；影像学检查的特征性变化有助于本病的早期诊断。本组７４例患者中，６８例获随访，平均随访时间１６个月，按我国４０分评定法，３０分以上者５８例（８５．３％）。结论脊髓型颈椎病早期诊断，早期施行手术治疗是提高脊髓型颈椎病疗效的重要因素。

Objectives To study early clinical characteristics and diagnosis of cervical spondylotic myelopathy and to search the timing of surgery. Method Seventy four cases of early diagnosed cervical spondylotic myelopathy (CSM) were treated with anterior cervical decompression and autologous iliac bone graft fusion. Result The early stage of CSM was indistinctive, and symptoms were mild. Neck pain,abnormality of motion and sensation of limbs, and hand and arm symptoms were shown frequently.Changes in neurological function could found during physical examination. Characteristic changes in imaging were helpful in early diagnosis of the disease. Conclusion Early diagnosis and surgery of CSM are important in improving the therapeutic results.