脊髓型颈椎病的发病机制及治疗的研究进展

Advancement on Pathogenesis and Treatment of Cervical Spondylotic Myelopathy

在中老年人群中脊髓型颈椎病是造成脊髓功能障碍的主要原因,其发病机制复杂,主要有静态和动态因素、缺血、内皮细胞损伤和血脊髓屏障的破坏、炎症及细胞凋亡等学说,每一种学说并不能够完美的解释脊髓型颈椎病的发病机制,仍需进一步实验研究探索其机制。对于进行性发展的脊髓型颈椎病多采用手术治疗,手术方式主要有前路、后路及前后路联合手术,如何选择手术方案仍是临床医生关注的焦点,本文就该病的发病机制及手术治疗的相关进展作一综述。

Cervical spondylotic myelopathy is the main cause of spinal cord dysfunction in the middle-aged and elderly populations.There are many theories about the complex pathogenesis of cervical spondylotic myelopathy, such as the static and dynamic factors, ischemia, endothelial cell loss and compromise of the blood-spinal cord barrier, neuro-inflammation and apoptosis, but none of them is able to fully interpret the pathogenesis of cervical myelopathy, as a result, further experimental study needs to be carried out so as to explore its mechanisms. In recent years, the operation methods have become more and more diversified, surgical treatment is widely used for progressive development cervical spondylotie myelopathy, and there are three main approaches： anterior approach, posterior approach, combination of anterior and posterior approach. How to choose the surgery project still reminds a focus of the clinicians. This paper carries out a summary based on the pathogenesis of the disease and the related progress of surgical treatment.