青少年颈椎病临床特征、X线特点及诊疗对策探讨

The Clinical features,X-ray Characteristics and Strategy in Diagnosis and Treatment of Cervical Spondylopathy in Teenagers

目的：通过对138例15~30岁青少年颈椎病患者临床特征及颈椎X片的分析,探讨诊疗对策。方法：统计临床症状和体征;均行DR-X线摄影机摄颈椎正位、中立位侧位、张口位平片检查,按照颈椎病诊断标准测量分析。结果：本组临床症状体征以颈型、椎动脉型、交感神经型为主;本组X片改变以颈椎小关节的紊乱引起颈椎失稳为主,以曲度的变直/反曲和椎体的轻度旋转错位为最突出的表现。结论：青少年颈椎病的眩晕/头晕症状与交感神经激惹引起椎动脉痉挛有关;青少年颈椎病是一种心身疾病;因X片特点是脊柱在水平、垂直、及旋转3D空间的复杂错位,故手法复位应是最主要的治疗方法,但扳法的应用需谨慎;中药的治疗不仅需要舒筋活络、活血通脉,还须注意对情志的调整。

Objective：To discuss the strategy in diagnosis and treatment of cervical spondylopathy in teenagers through analyzing the clinical features and x-ray characteristics in 138 cases.Methods：We collected the clinical symptoms and signs of the patients.All patients had X-ray of the cervical vertebrae at normal,lateral and mouth-open position.Results：The main types were cervical type,vertebral artery type and sympathetic nerve type.The main change was cervical instability due to dislocation of small cervical joints,which was remarkably manifested as the disappearance or retroflexion of the curve,and the rotation dislocation.Conclusion：The vertigo and dizziness in cervical spondylopathy teenagers are mainly caused by spasm of vertebral artery.Teenage cervical spondylopathy is a psychosomatic disease.Due to the complex dislocation of the spine at horizontal,vertical and rotational levels,manipulation should be the main therapy,but pulling manipulation should be used with caution.When Chinese medicine is adopted,it is not only necessary to relax the muscles and collaterals,and activate the blood flow,but also should be focused on the regulation of emotions.