分离性上肢运动障碍型颈椎病的诊断与治疗

Diagnosis and treatment of cervical spondylosis with dissociated motor loss in upper extremity

目的 :探讨分离性上肢运动障碍型颈椎病的诊断、鉴别诊断、治疗及发病机理。方法 :综合分析 4例病人的临床症状、体征、影像学资料和诊治过程及预后。结果 :2例行手术治疗的病人均有恢复 ,另 2例保守治疗的病人则无恢复。结论 :该型颈椎病因症状、体征和常见的神经根型及脊髓型有较大差异而不易诊断 ,易与神经内科病特别是运动神经元病相混淆而漏诊、误诊 ,提高对这种少见的非典型颈椎病的认识 ,尽早明确诊断和选择手术治疗对该病的预后有重要意义。

Objective:To explore the pathogenesis and clinical features of the special type spondylosis of dissociated motor loss in upper extremity and its differential diagnosis and treatment.Method:Comprehensively analysing the features of symptoms and signs in four patients and their image results,the processes of diagnosis and treatment and their prognoses.Results:2 patients who underwent operations with anterior discectomy and fusion gained recovery, but the other 2 patients treated by conservative method showed no improvement.Conclusion:The special and uncommon cervical spondylosis is easy misdiagnosized because it is apt to be confused with motor neuron disease.Early reliable diagnosis and operative treatment is necessary. Author′s address\ Department of Orthopeadics, Xiangya Hosptial,Hunan Medical University,Changsha,Hunan,410001