颈椎病术后第5颈椎神经根麻痹的临床研究

The study of the C_5 nerve root palsy after surgery of cervical spondylosis

目的探讨颈椎病术后第5颈椎(C5)神经根麻痹的临床表现、治疗及预后。方法我院骨科1994年3月至2003年10月手术治疗223例颈椎病,对术后出现C5神经根麻痹的7例患者的临床资料进行回顾性分析。结果223例患者7例术后发生C5神经根麻痹,表现为三角肌瘫痪,肩部感觉减退,牵扯痛等,发生率为3.1%。前路椎体次全切除术中发生2例;后路单开门颈椎管扩大成形术中发生5例(开门侧1例,铰链侧3例,双侧1例)。7例患者术后2周～6个月内逐渐恢复。结论颈椎病前、后路手术中均可能发生C5神经根麻痹,保守治疗即可痊愈,预后良好。

Objective To explore the clinical features,treatment and prognosis of the C_5 palsy after surgery of cervical spondylosis. Methods Two hundred and twenty-three cases treated from March 1994 to October 2003 were retrospectively reviewed. Results Seven of the 223 cases developed the complication of C_5 palsy ,manifesting the paresis of the deltoid muscle as well as the sensory deficits and(or) intractable pain in shoulder. The incidence was 3.1%. In this study, 2 cases occurred in the anterior subcorpectomy, 5 cases developed in the laminoplasty with 1 case on the opened side, 3 cases on the hinged side and 1 case on both sides. All the 7 cases with the C_5 palsy recovered within 2 weeks to 6 months. Conclusion The C_5 palsy can develop either anterior decompression or posterior open-door laminoplasty of cervical spondylosis. Generally speaking, patients with postoperative C_5 palsy can be cured by conserative measures. And prognosis is good.