脊髓型颈椎病的研究进展

doi:10.3969/j.issn.1006-9771.2019.08.002

摘要/Abstract

摘要： 脊髓型颈椎病是颈椎病最为严重的亚型，也是脊髓损伤最常见的原因。目前认为除了椎管狭窄造成的机械压迫和缺血性改变构成其病理生理基础外，颈椎的动态不稳也是造成脊髓损伤的重要因素。其临床表现及查体复杂多样，常常需要与一些老年病相鉴别，除表现为上运动神经元损伤所致的异常长束征，约51.9%的脊髓型颈椎病患者同时伴有根性病变。可疑脊髓型颈椎病者，磁共振成像为首选检查方法，弥散张量成像检测早期患者的敏感性更高。建议中、重度脊髓型颈椎病患者进行手术治疗，轻度患者自诊断开始3年之内可考虑保守治疗。

关键词: 脊髓型颈椎病, 治疗, 综述

Abstract: Cervical spondylotic myelopathy is the most serious subtype of cervical spondylosis and the most common cause of spinal cord injury. At present, it is considered that mechanical compression and ischemic changes caused by spinal stenosis constitute the pathophysiological basis of spinal stenosis, and the dynamic instability of cervical spine is also an important factor causing spinal cord injury. Its clinical manifestations and physical examinations are complex and varied, and often need to be differentiated from some geriatric diseases. In addition to the abnormal long bundle sign caused by upper motor neuron injury, about 51.9% of cervical spondylotic myelopathy patients also have root lesions. Magnetic resonance imaging is the preferred method of examination in patients with suspected cervical spondylotic myelopathy. Compared with magnetic resonance imaging, diffusion tensor imaging is much more sensitive in detecting early patients. It is suggested that, patients with moderate to severe cervical spondylotic myelopathy should receive surgery, and patients with mild cervical spondylotic myelopathy should consider conservative treatment within three years from the beginning of diagnosis.

Key words: cervical spondylotic myelopathy, treatment, review

中图分类号:

R681.5

陈亮, 王冲, 高峰, 王玉明, 李建军. 脊髓型颈椎病的研究进展[J]. 《中国康复理论与实践》, 2019, 25(8): 875-881.

CHEN Liang, WANG Chong, GAO Feng, WANG Yu-ming, LI Jian-jun. Advance in Cervical Spondylotic Myelopathy (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(8): 875-881.

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