中央型颈椎间盘突出症

Central herniation of cervical intervertebral disc

４３例中央型颈椎间盘突出症病例，均累及颈髓引起不同程度的痉挛瘫。本组均无颈部外伤史。６５％的病例颈椎Ｘ线平片无异常所见；６０％的病例仅单间隙突出；７％的病例呈跳跃型多间隙突出；上位颈椎突出约占全部突出间隙的１４％．本组有两种临床类型：亚急性突出和缓慢型突出。游离髓核偶可刺破后纵韧带，突入椎管内甚至硬膜下腔，引起急性严重四肢瘫。缓慢突出型常为多间隙突出，少数合并后纵韧带钙化、骨化。３５例经前路间盘切除、椎间植骨融合；２例行椎管成形术。１例前路减压不彻底、半年后再行单纯椎板切除。平均随访７年月，９７％获得优良疗效，无手术并发症和加重例。

It's reported that 43 cases with central herniation of cervical intervertebral disc complicated by cervical myelopathy since 1989. MRI is of great value for the diagnosis and differential diagnosis. There were two clinical types, subacute and chronic 65 percent of cervical X-rays weres normal. in our group simple cervical disc herniation were observed in many caees Three patients sufered from ruptuer of posterior longitudinal ligament, and in one of them, the dura mater was also broken up. The free nuclear material mass was forced into the cervical canal or nitradural cavity. 35 cases with myelopathy had received disc excision and fusion of the interbody; 3 cases with OPLL had been performed using unilateral hinged expansive-canal laminoplasty or lamineotomy. Those patients had got a good result.