退行性下颈椎不稳定症的诊断与治疗

Diagnosis and Treatment of Lower Cervical Vertebral Degenerative Instability

目的:探讨下颈推不稳症的诊断标准及治疗方法。方法:总结了2004年5月～2007年9月我科42例退行性下颈椎不稳症采用颈前路减压自体髂骨植骨和钢板内固定术的患者,其中:男29例,女13例。年龄(45～68)岁,平均56.5岁,占同期手术治疗颈椎病例的25.7%。结果:本组病例临床表现为肩臂部疼痛、头痛、头晕、恶心呕吐、手部麻木、抖方肌、提肩肿肌压痛等,影像学检查表现为颈椎椎间隙狭窄、骨赞形成、生理弯曲消失、椎体间位移大于等于3.5mm或椎体间位移1mm～3mm呈阶梯样改变。全部病例随访(10～35)个月,平均随访20.5个月,术后疗效为优良33例,可例5例,差4例,优良率78.6%。结论:退行性下颈椎不稳定症,经正规保守治疗无效,应尽早采用颈前路减压自体髂骨植骨和钢板内固定术稳定,具有良好的治疗效果。

Objective： vertebral To investigate the diagnostic criteria and treatment method of lower cervical degenerative instability. Methods： 42 patients of lower cervical vertebral degenerative instability treated by anterior decompression,auto lilac bone graft and plate fixation, including 29 male and 13 female. The range of age was between 45 and 68, and the average was 56.5. The ratio was 25.7% compared with those treated by surgery of Cervical Spondylosis. Results： The clinical manifestation of this group cases were as follows： pain of shoulder and arm, headache, dizziness, nausea and vomiting, numbness of arm, tenderness of quake quadratus and extract shoulder lump muscle and so on. The manifestation of imaging examination were as follows： Stenosis of vertebral gap between cervical spine, the formation og bone zan, vanishing of physiological curvature, interoposition between interbody greater than or equal to 3.5 nm, or changes like ladder of interoposition tetween interbody within I mm- 3 mm. All the patients were followed-up for 10-- 35 monthes, average 20.5 mouthes. The efficacies of 33 patients were excellent, and the ratio of excellent was 78.6%. Conclusion： If no efficacy of lower cervical vertebral degenerative instability treated by treated by conservative treatmen4 anterior deeompression,auto iliac bone graft and plate fixation should be used earlier, and it could caused excellent efficacy.