Rowland L P
Neurological Institute, Columbia-Presbyterian Medical Center, New York, NY 10032-3784.
Neurology. 1992 Jan;42(1):5-13. doi: 10.1212/wnl.42.1.5.
Surgical procedures on the cervical spine are accepted therapies for the myelopathy of cervical spondylosis. However, reported improvement rates vary widely, and many reports indicate improvement in about one-half of the cases. It has not been proven that outcome after surgery is better than the natural history or conservative therapy. Radiographic or imaging evidence of cord impingement or compression may be seen in asymptomatic people. There are no clear guides to the selection of patients who may benefit from the operation and there has been no standardization of preoperative evaluation, trials of conservative therapy, ascertainment of progressive disability, or assessment of outcome. A multicenter controlled trial might answer these questions.
颈椎手术是治疗颈椎病脊髓病的公认疗法。然而，报告的改善率差异很大，许多报告表明约一半的病例有改善。目前尚未证实手术效果优于自然病程或保守治疗。在无症状人群中可能会出现脊髓受压或受撞击的影像学证据。对于哪些患者可能从手术中获益，目前尚无明确的选择指南，术前评估、保守治疗试验、确定进行性残疾或评估手术效果也未实现标准化。一项多中心对照试验或许可以回答这些问题。
