Orr R D, Zdeblick T A
Division of Orthopaedic Surgery, Hamilton Health Sciences Corporation, Ontario, Canada.
Clin Orthop Relat Res. 1999 Feb(359):58-66.
Cervical spondylotic myelopathy is the leading cause of spinal cord dysfunction in older patients. This review article looks at the natural history of the condition and examines the role of different surgical treatments for it. Anterior and posterior surgical approaches have a role in the treatment of cervical spondylotic myelopathy dependent on the number of levels involved and the alignment of the spine. Anterior decompression and fusion is useful in patients who have disease at three or fewer levels or in patients with kyphotic alignment. In more extensive disease, a posterior decompression and fusion is usually best. Canal expansive laminoplasty is useful in the treatment of myelopathy without radiculopathy in a patient with lordotic alignment. With the exception of laminoplasty, nonfusion procedures have little role in the treatment of cervical spondylotic myelopathy.
脊髓型颈椎病是老年患者脊髓功能障碍的主要原因。这篇综述文章探讨了该疾病的自然史，并研究了不同手术治疗方法在其中的作用。前路和后路手术方法在脊髓型颈椎病的治疗中发挥着作用，这取决于受累节段的数量和脊柱的排列情况。前路减压融合术适用于病变节段为三个或更少的患者或存在后凸畸形的患者。对于病变范围更广的疾病，通常最好采用后路减压融合术。椎管扩大成形术适用于前凸畸形患者的无神经根病型脊髓病的治疗。除了成形术外，非融合手术在脊髓型颈椎病的治疗中作用不大。
