退行性颈脊髓病的诊断和治疗进展

Progress of diagnosis and treatment for degenerative cervical myelopathy

退行性颈脊髓病(DCM)是因颈椎退变造成颈脊髓受压、损伤的一类疾病, 随着我国老龄化人口的不断增加, DCM发病率也逐年增高。DCM发病机制可分为静态的退变和动态的不稳两方面因素。DCM临床表现主要为颈脊髓损害的症状和体征。磁共振成像(MRI), 特别是一些先进的定量微结构MRI, 对早期诊断DCM有着重要的作用。DCM患者保守治疗往往疗效不佳, 大部分患者需要进行手术解除神经压迫, 手术入路选择目前尚存争议。患者症状的持续时间长、术前的神经功能状态差和高龄是造成术后疗效不佳的主要因素。本文主要介绍关于DCM发病率、发病机制、诊断、评估和治疗的近年来的研究进展。

Degenerative cervical myelopathy(DCM)is a kind of disease caused by cervical spinal cord compression and injury due to cervical degeneration.With the increasing of aging population in China,the incidence of DCM is also increasing year by year.The pathogenesis of DCM includes static degeneration and dynamic instability.The clinical manifestations of DCM are mainly symptoms and signs of cervical spinal cord dysfunction.Magnetic resonance imaging(MRI),especially some advanced quantitative microstructural MRI,plays an important role in the early diagnosis of DCM.Conservative treatment of DCM patients is often ineffective,and most patients need surgery to relieve nerve compression,and the surgical approach selection is still controversial.The long duration of symptoms,poor preoperative neurological status and advanced age were the main factors that caused the poor postoperative outcome.This article mainly reviews the recent research progress on the incidence,pathogenesis,diagnosis,evaluation and treatment of DCM.