脊髓型颈椎病伴大块椎间盘突出保守治疗1例及文献回顾

Conservative treatment of cervical spondylitic myelopathy with a large cervical disc herniation: a case report and review of literature

目的探讨脊髓型颈椎病治疗方案选择及突出椎间盘自然吸收的机制。方法临床报道1例脊髓型颈椎病伴大块椎间盘突出保守治疗的病案,对脊髓型颈椎病治疗方案选择及突出椎间盘自然吸收的相关文献进行回顾。结果脊髓型颈椎病治疗方式分手术和保守两种,手术疗法相对于保守疗法对于脊髓型颈椎病患者的优点和缺点仍然有争议。突出椎间盘自然吸收机制尚不明确。结论早期诊断并给予恰当的治疗对脊髓型颈椎病患者至关重要,因为可以显著改善预后。突出椎间盘自然吸收机制仍需要进一步研究。

Objective To explore the choice of treatment programs of cervical spondylitic myelopathy and the cause of natural absorption of herniated cervical intervertebral disc. Methods A case of cervical spondylitic myelopathy with a large cervical disc herniation treated with conservative treatment was reported. The literature of about the controversy on surgical and conservative treatment of cervical spondylitic myelopathy and natural absorption of herniated cervical intervertebral disc was reviewed. Results The treatment manners of cervical spondylitic myelopathy include two types, namely, surgical treatment and conservative treatment. Surgery is the preferred treatment for cervical spondylitic myelopathy because traction and manipulation cannot be applied on some patients with cervical spondylitic myelopathy. The advantages and disadvantages of surgical versus conservative treatment for patients with CSM remain controversial. The mechanism of natural absorption of herniated cervical intervertebral disc is unclear. Conclusion Early diagnosis and treatment are of great importance for patients with CSM because they can significantly affect their prognosis. The mechanism of natural absorption of herniated cervical intervertebral disc needs further research.