脊髓型颈椎病与发育性颈椎管狭窄38例

A study on cervical spondylotic myelopathy and developmental cervical spinal canal stenosis

目的 探讨发育性颈椎管狭窄与脊髓型颈椎病的发病关系及其临床意义。方法 10 0例确诊为脊髓型颈椎病的患者 ,经复查原始X线颈椎侧位片 ,并按照颈椎管矢状中径与颈椎体矢状中径比值法进行重新测量。其中手术患者 2 4例 ,前路手术 8例 ,后路手术 16例。结果 10 0例脊髓型颈椎病患者中有 38例存在不同程度的发育性颈椎管狭窄。前路手术随访 3例中 ,有 2例加重 ,再行后路手术后明显改善 ;后路手术随访 6例中 ,有 4例完全恢复 ,1例因前方巨大间盘突出并骨化 ,再行前路手术后明显改善 ,另 1例术后部分改善。结论 颈椎管发育性狭窄是脊髓型颈椎病发病的决定性因素之一 。

Objective To investigate the relationship between developmental cervical spinal canal stenosis and cervical spondylotic myelopathy and clinical significance. Methods In the retrospective study, 100 cases, who were finally diagnosed as cervical spondylotic myelopathy, were analysed by reviewing the original lateral cervical vertebrae X ray and measuring the middle sagittal diameter ratio of vertebral canal and vertebral body. Among these cases, 24 were operated: anterior operation (AO) for 8 cases, posterior operation (PO) for 16 cases. Results 38 cases of the group were found developmental cervical spinal canal stenosis in different degrees. In the follow up, 2 out of 3 cases undergone AO were deteriorated and improved ofter reoperation of PO, whereas among 6 cases treated by PO, 4 were full recovered; 1 partial recovered; and 1, because of anterior great disc protrusion associated with ossification, was reoperated (PO) and improved much better after it. Conclusion Developmental cervical spinal canal stenosis is one of the risk factors of cervical spondylotic myelopathy, so it is important to recognize it for selecting right operational method to acquire good prognosis.