颈椎病脊髓功能量化计分的改进及其意义

DESIGN OF QUANTITATIVE SCORE SYSTEM FOR CERVICAL SPONDYLOTIC MYELOPATHY AND COMPARASION WITH TRADITIONAL METHODS

目的通过对传统脊髓功能计分法的改进，设计出一种新的量化计分法，以期更客观、准确地评价颈椎病性脊髓病（ＣＳＭ）病人的脊髓功能及疗效改善情况。②方法通过将颈部、躯干和四肢的腹、背侧划分为２００个方格进行感觉异常的体表面积量化计分；对全身２５块（组）主要骨骼肌进行肌力障碍量化计分；对２１种体征检查中有异常者进行量化计分。以上３种分值相加即为病人的脊髓功能障碍分值。对２４例颈椎病性脊髓病病人术前１ｄ及术后３０，９０ｄ同时进行新量化计分法和殷华符４０分计分法评分并加以比较。③结果本组２４例病人，术后３０，９０ｄ新量化计分法脊髓功能改善率均高于殷华符４０分计分法（ｕ＝４．０４，３．３３，Ｐ均＜０．０１）。④结论新计分法可更准确、全面地反映ＣＳＭ病人的脊髓功能。

Objective A new quantitative score system was designed in an attempt to make the evaluation of spinal cord function and therapeutic improvement more accurate and objective, through the modification of several traditional methods.Methods This system included three parts: quantitative paresthesia of the belly and dorsa of neck, trunk and extremities by way of surface area nomograph divided into 200 blocks; quantitative myodynamic disturbance score to the 25 chief single or groups of skeletal muscles; quantitative physical sign score only to the abnormal ones. Therefore, the disturbance score of patient's spinal cord function equaled to the total score of the above three. 24 cases of cervical spondylotic myelopathy were scored and compared one day before surgery, 1 month and 3 months after surgery by the new quantitative score system and Yin Huafu's 40 score method simultaneously. Results For all of the 24 cases, the improvement ratio of the new system 1 month and 3 months after operation were much higher than that of Yin Huafu's method(u=4.04,3.33, P<0.001). Conclusion The new quantitative score system is much more accurate and scientific to reflect the spinal cord function and its therapeutic effect compared to traditional ones.