探讨交感型颈椎病的手术疗效

Surgical management of the sympathetic cervical spondylosis

目的探讨交感型颈椎病手术治疗的效果。方法回顾性分析本组22例交感型颈椎病的手术疗效,男8例,女14例,年龄42～76岁,中位年龄(59.68±9.75)岁,病程12～120个月,平均(30.73±31.60)个月。术前22例患者,颈椎正侧位及动力位均提示颈椎不稳,交感神经症状包括:头晕、头痛、眩晕、恶心、呕吐、耳鸣、视物模糊、心慌等。交感神经症状评价采用20分评分法及患者主观满意度评定法(分为优、良、中、差4个等级)。结果 22病例均获得随访,术后随访时间5～43个月,截至末次随访,平均(19.33±12.97)个月,术前交感症状20评分3～8分;平均(5.09±1.95)分;末次随访0～2分,平均(0.64±0.65)分,差异有统计学意义(P<0.05);患者主观满意度评价:优13例,良6例,中2例,差1例,优良率86.4%。术后X线片均显示植骨融合。结论颈椎间盘退变是颈椎不稳的病理基础,颈椎不稳是导致交感型颈椎病的重要因素。因此,手术治疗退变性颈椎不稳所致的交感型颈椎病有良好的疗效。

Objective To investigate the effect of surgical treatment of the sympathetic cervical spondylosis.Methods 22 cases with sympathetic cervical spondylosis,8 males and 14 females,aged 42-76 years,median age of（59.68±9.75） years,were studied.Their courses of disease were from 12 to 120 months with the average of（30.73±31.60） months.All the cases have shown that cervical instability in the X ray,and the sympathetic symptoms include：dizziness,headache,vertigo,nausea,vomiting,tinnitus,blurred vision,nervousness and so on.Sympathetic symptoms were evaluated by the 20 points score and by subjective patient satisfaction assessment（4 grades：excellent,good,fair,and poor）.Results All patients were followed up for 5-43 months,the average were（19.33±12.97） months,preoperative sympathetic symptoms of 20 score were 3 to 8 points,with the average of（5.09±1.95） points,and that of 0-2 minutes postoperatively were（0.64±0.65） points.There was statistical significance（P〈0.05） between them.The results of subjective patient satisfaction assessment were：excellent in 13 cases,good in 6 cases,fair in 2 cases and poor in 1 case,and excellent rate was 86.4%.Postoperative X-ray of all the cases showed good fusion.Conclusion Cervical instability is an important factor in sympathetic cervical spondylosis,and the disc degeneration is a prominent cause which lead to the instability.The surgical management has a good effect on treatment of sympathetic cervical spondylosis.