摘要
目的总结颈椎减压术后C_(5)麻痹发生的可能原因。方法广泛查阅近年国内外有关C_(5)麻痹研究文献,结合临床实践经验对C_(5)麻痹发生原因进行分析。结果目前C_(5)麻痹发生原因主要包括神经根拴系和脊髓损伤两种学说,但均存在一定局限性。前者不能解释颈椎前路手术后C_(5)麻痹的发生,后者无法解释C_(5)麻痹的发生往往表现为上肢部分肌肉的运动功能障碍。结合临床实践分析颈椎前路手术后C_(5)麻痹的发生与术中器械损伤脊髓前角有关,颈椎后路手术后C_(5)麻痹的发生与减压后脊髓后移导致的神经根拴系有关。结论针对颈椎减压术后C_(5)麻痹发生的主要原因,提倡减少手术器械对脊髓的挤压,以降低该并发症发生风险。
Objective To review the definition and possible etiologies for C_(5) palsy.Methods The literature on C_(5) palsy at home and abroad in recent years was extensively reviewed,and the possible etiologies were analyzed based on clinical practice experience.Results There are two main theories(nerve root tether and spinal cord injury)accounting for the occurrence of C_(5) palsy,but both have certain limitations.The former can not explain the occurrence of C_(5) palsy after anterior cervical spine surgery,and the latter can not explain that the clinical symptoms of C_(5) palsy is often the motor dysfunction of the upper limb muscles.Based on the previous reports,combining our clinical experience and research,we propose that the occurrence of C_(5) palsy is mainly due to the instrumental injury of anterior horn of cervical spinal cord during anterior cervical decompression.In addition,the C_(5) palsy following surgery via posterior approach may be related to the nerve root tether caused by the spinal cord drift after decompression.Conclusion In view of the main cause of C_(5) palsy after cervical decompression,it is recommended to reduce the compression of the spinal cord by surgical instruments to reduce the risk of this complication.
作者
郭川
宋心月
孔清泉
王玉
伍椰
李韦龙
GUO Chuan;SONG Xinyue;KONG Qingquan;WANG Yu;WU Ye;LI Weilong(West China School of Medicine,Sichuan University,Chengdu Sichuan,610041,P.R.China;Department of Orthopedics,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2022年第3期376-379,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
颈椎减压
C_(5)麻痹
神经根
脊髓
Cervical decompression
C_(5)palsy
nerve root
spinal cord