发育性颈椎椎管狭窄症

The developmental stenosis of cervical spinal canal

测量５０例颈椎骨干标本，确定男１１ｍｍ，女１０ｍｍ以下为狭窄椎管。１０具成人固定标本观察在最大伸、屈位时，脊髓变短，硬膜褶皱，间盘黄韧带截面矢径变小。统计病人１３例，占同期颈椎病性脊髓病的１８．６％；年龄超过５０岁者１０例，９例病程超过半年。首发症状为进行性下肢麻木无力，颈、胸平面以下不同程度痛觉减退，锥体束征阳性。Ｘ线平片测量、脊髓造影、ＣＴ或ＣＴＭ皆示椎管发育性狭窄。行椎板切除１例，后路椎板扩大成形１２例，除椎板切除１例远期效果欠佳外，余皆有明显改进。作者提出了本症的特征及诊断条件，认为确诊后以单开门椎管扩大成形、棘突骨支撑植骨术为佳。

Thirteen cases of developmetal stenosis of cervical spinal canal (DSCSC). about 18. 6 % of the observed cervical spondylotic myelopathy, were analyzed. 77% were over 50 years old and in 69% their symptoms had been appeared over 6 months before their admission. The early clinical symptoms were gradual paresthesia and weakness of legs. Their skin pain threshold were lowered below neck or thoracic level. The knee and ankle jerks were increased, the ankle clouns was postive, and the Qukenstedt test showed a partial block. The plain rediography, Myelography, and CT or CTM had shown that the saggital diameter of the spinal canal was narrow and the cord was compressed. All the patients but one, were treated by en bloc laminoplasty with good results.