颈髓减压术后颈节段性神经根麻痹

Segmental root palsy (SRP) after cervical decompression surgery

目的:探讨颈髓减压术后颈节段性神经根(特别是C5神经根)麻痹的发生、防治及预后情况。方法:自2006年2月至2008年12月行前路或后路颈髓减压患者162例,其中10例术后出现颈节段性神经根麻痹,男6例,女4例;年龄40～68岁,平均53岁。采用脱水、营养神经、高压氧等治疗,并随访观察,对其临床资料进行回顾分析。结果:10例患者均获得随访,时间8个月～3年,平均2.4年。术前颈髓压迫症状均有不同程度好转,节段性神经根麻痹症状在术后3周～8个月内逐步缓解至完全恢复,平均恢复时间4.4个月。结论:颈节段性神经根(特别是C5神经根)麻痹是各种颈髓受压疾患行减压术后常见的并发症之一,前路或后路颈髓减压手术中均可发生,是以神经根栓系效应为主的多种发病机制共同作用的结果,发病后尚缺乏确实有效的防治方法,一般选择保守治疗,预后良好。

Objective：To explore the occurrence,prevention and cure prognosis of segment root polsy （especially in C5 palsy） after cervical decompression surgery. Methods：From February 2006 and December 2008,162 patients were operated with cervical decompression through approach for anterior or posterior in our hospital. Among them,10 cases occurred SRP after operation included 6 males and 4 females aged from 40 to 68 with an average of 53 years old. These cases were treated with dehydration,trophic nerve,hyperbaric oxygenation. The clinical data were retrospective analzed. Results：Ten patients were followed up from 8 months to 3 years with an average of 2.4 years. It was observed that all the patients recovered during a period of 4.4 months on average （ranging from 3 weeks to 8 months）. Conclusion：SRP（especially in C5 palsy） is one of the common complications of anterior or posterior cervical decompression surgery. SRP is usually the result of various nosogenesis. As there was no effective treatment,conservative treatment is usually adopted with optimistic prognosis.