摘要
目的报告伴交感神经症状颈椎病的临床评价方法及其初步结果。方法回顾性分析2002～2007年本治疗组伴交感神经症状的颈椎病患者47例，其中男19例，女28例，男女比例为1：1．5；年龄为34～72岁，平均50．5岁。入选条件：①明确诊断为脊髓型或神经根型＼脊髓神经根混合型颈椎病。②均有交感神经症状。③患者均行颈前路减压植骨融合内固定手术，术中均切除后纵韧带。其中8例术前影像学显示有椎节不稳，其余患者未见明显钩椎关节骨质增生及颈椎不稳。交感神经症状包括：眩晕，头痛，恶心呕吐，耳鸣，视物模糊，心慌，记忆力下降，心动过速或心动过缓或早搏等心电图异常，胃肠道症状，面部潮红，出汗等。交感神经症状评价采用20分评分法及患者主观满意度评定。患者主观满意度分为优、良、可、差4个等级。结果所有患者术后均获10～48个月随访，术前交感症状评分6．0分；术后2．8分；患者主观满意度19例为优，16例为良，8例为可，4例为差，有效率为87．5％。结论切除后纵韧带的颈前路减压植骨内固定术对交感神经症状具有一定治疗作用。
Objective To report the primarily results of clinical evaluation on patients with cervical degenerative spendylosis companied by sympathetic symptoms. Methods 47 cases suffered from cervical spendylosis from 2002 to 2007 were retrospectively reviewed. There were 19 male and28 female, the ratio of male to female was 1：1.5. And the age of these consecutive patients was from 34 years old to 72 years old with average age 50.5 years old. The inclusive criteria were （1） cervical myelopathy or radiographic or both secondary to cervical degenerative disease, （2） complaining of unexplainable and irrelievable sympathetic symptoms, （3） performed with anterior cervical decompression with PLL resection and internal fixation. Except 3 cases with radiological demonstration of cervical instability, there was no instability and osteophyte in Luschka joint was found in this group. The sympathetic symptoms included dizziness, vertigo, headache, vomiting, tiunitus, heart-throb, hypomnesia, tachycardia, gastroenterological system symptoms, sweatiness etc were evaluated by both 20 points evaluation system and patient＇s satisfaction evaluation. The patient＇s satisfaction evaluation was divided as excellent, good, fair and poor. Results All the patients were followed up from 10 to 48 months （ average 26 months）. The sympathetic symptom scores were 6.0 before operation and 2.8 after operation. The satisfactory evaluation was excellent in 19 cases, good in 16, fair in 8 and poor in 4. The effective rate was 87.5%. Conclusion The anterior cervical decompression with resection of the PLL can relive the symptoms of the patients with cervical spendylosis companied by sympathetic symptoms.
出处
《脊柱外科杂志》
2007年第4期193-197,共5页
Journal of Spinal Surgery
基金
国家自然科学基金资助项目(30571889)
关键词
颈椎
颈椎病
交感神经系统
纵韧带
眩晕
cervical vertebrae
cervical spendylosis
sympathetic nervous system
longitudinal .ligaments
vertigo
