不典型脊髓型颈椎病的诊断和治疗

Atypical Cervical Spondylotic Myelopathy:Diagnosis and Treatment

目的 探讨症状和体征不典型的脊髓型颈椎病 (cervicalspondyloticmyelopathy ,CSM)的临床表现及其诊断治疗。方法 对过去 4年中 7例不典型颈椎病的诊断治疗进行回顾分析。其中 4例行前路椎间盘髓核摘除、椎间植骨和钢板内固定 ,3例行后路椎管单开门扩大成形术。结果 按JOA评分标准 :优 4例 ,良 2例 ,中 1例。结论 不典型CSM应遵循早诊断、早治疗的原则 ,及时的手术治疗可以取得良好效果。

Objective To study diagnosis and treatment to the patients with cervical spondylotic myelopathy (CSM) which symptoms and signs are atypical.Methods Reviewed the data of 7 cases of CSM combined without characteristic symptoms and signs in the necks, shoulders and upper limbs during the past 4 years.4 cases received anterior intervertebral disc resection, autogenous iliac grafting and internal fixation with Orion or Zipher plate, the other 3 cases got posterior expansive open-door laminoplasty.Results JOA recovery scores were excellent in 4 cases, good in 2 cases and median in 1 case.Conclusions Early diagnosis and timely surgery treatment should be the principle in this disease and good results can be expected.