椎管性脑脊液循环不良综合征

Vertebral cerebrospinal fluid poor circulation syndrome

目的研究椎管性脑脊液循环不良综合征的病因、机制、临床表现和MRI表现。方法收集并归纳整理1392例脊柱病人临床和MRI资料,分析椎管各种病变的特点。结果所有病例都有不同程度的椎管狭窄,脑脊液循环不良和其所引起的临床表现。常见症状依次为头晕、四肢无力、记忆力下降、下肢无力、失眠、胸闷、上肢无力、颈背肌僵硬等。不同年龄段常见的临床表现不同,37岁以上患者临床表现多样化显著。腰骶段和颈段发病率较高。常见MRI异常表现依次为椎体后缘增生,蛛网膜下腔变窄,椎间盘突出,小关节失衡,侧隐窝狭窄,黄韧带肥厚,后纵韧带肥厚,脊髓变性,脊柱肌群张力失衡等。结论椎管性脑脊液循环不良综合征临床表现多样,MRI可充分显示其病因,评价其病情,帮助临床提供诊断依据。

Objective To study and evaluate the causes,mechanisms,clinical symptoms and signs and MRI manifestations of vertebral cerebrospinal fluid poor circulation syndrome.Methods The clinical and MRI data of 1392 patients for spinal lesions were collected and analyzed.The features of different kinds of spinal lesions were analyzed.Results Various degrees of spinal stenosis,poor circulation of cerebrospinal fluid and the corresponding clinical symptoms and signs were found in all cases.Common symptoms by turns were dizziness,general fetigue,memory degression,lower limb weakness,insomnia,chest distress,upper limb weakness neck and back muscles stiffness.The common clinical manifestations were various in different age groups lumbosacral and cervical segments were of a higher attack rate.The clinical manifestations were markedly increased after 37 years old.The common abnormalities of MRI manifestations by turns were vertebral hyperosteogeny of posterior margin,subarachnoid space narrowing,disc herniation,facet joint imbalance,lateral recess stenosis,the ligamentum flavum hypertrophy,posterior longitudinal ligament hypertrophy,spinal degeneration,spinal muscles tension imbalance and so on.Conclusion The clinical symptoms and signs of vertebral cerebrospinal fluid poor circulation syndrome are diverse.MRI could show sufficiently the causes of vertebral cerebrospinal fluid poor circulation,evaluate their conditions and assist clinical diagnosis.