Liu Xian-Yi, Li Chun-De, Yi Xiao-Dong, Li Hong, Yu Zheng-Rong
Orthopedic Department, Beijing University First Hospital, Beijing 100034, China.
Zhonghua Yi Xue Za Zhi. 2007 Dec 18;87(47):3339-42.
To investigate the clinical characteristics and treatment of cervical spondylotic amyotrophy.
9 cervical spondylotic amyotrophy patients and 15 cervical radiculopathy, myelopathy spondylosis patients were included in this study. Their clinical manifestation, MRI image results and treatment were analysis. Of 9 cervical spondylotic amyotrophy patients, 7 cases were done with cervical discectomy, 2 cases were done with combined cervical anterior and posterior operation; of 15 radiculopathy, myelopathy spondylosis patients, 12 cases were done with cervical discectomy, 3 cases were done with combined cervical anterior and posterior operation.
Cervical spondylotic amyotrophy patients were followed up 6-36 months, muscle power of 9 patients were improved markedly, muscle power of 6 patients were improved from grade II preoperation to grade IV-V postoperation after operation 6 months, relief rate is 75%-100%, that of 2 patients were improved from grade III preoperation to grade IV-V postoperation, relief rate is 50% and 100% respectively, that of 1 patient (multiple segments) were improved from grade I preoperation to grade III postoperation, relief rate is 50%; 8 patients were followed up over 12 months, muscle power of 7 patients were improved to grade V, relief rate is 100%, that of 1 patient were improved to grade IV, relief rate is 80%. Cervical radiculopathy, myelopathy spondylosis patients were followed up 12-36 months, muscle power of 15 patients were improved respectively, muscle power of 15 patients were improved from grade II-IV preoperation to grade III-V postoperation after operation 6 months, relief rate is 20%-100%, all 15 patients were followed up over 12 months, muscle power of 11 patients were improved to grade V, relief rate is 100%, that of 3 patient were improved to grade IV, relief rate is 20%-50%, that of 1 case keep unchanged.
Cervical spondylotic amyotrophy is a rare type of cervical spondylotic disorder, it is easily misdiagnosed because it is confused with motor neuron disease. MRI and electromyography can help to diagnose. The mechanism of cervical spondylotic amyotrophy maybe is that compression of anterior horn of spinal cord or ischemic injury of spinal cord. Surgical treatment can help to improve muscle power, prognosis of single segment is better than that of multiple segments.
探讨脊髓型颈椎病性肌萎缩的临床特点及治疗方法。
本研究纳入9例脊髓型颈椎病性肌萎缩患者和15例神经根型、脊髓型颈椎病患者。对其临床表现、MRI影像结果及治疗情况进行分析。9例脊髓型颈椎病性肌萎缩患者中，7例行颈椎间盘切除术，2例行颈椎前后联合手术；15例神经根型、脊髓型颈椎病患者中，12例行颈椎间盘切除术，3例行颈椎前后联合手术。
脊髓型颈椎病性肌萎缩患者随访6 - 36个月，9例患者肌力明显改善，6例患者术后6个月肌力从术前Ⅱ级提高到术后Ⅳ - Ⅴ级，缓解率为75% - 100%，2例患者肌力从术前Ⅲ级提高到术后Ⅳ - Ⅴ级，缓解率分别为50%和100%，1例（多节段）患者肌力从术前Ⅰ级提高到术后Ⅲ级，缓解率为50%；8例患者随访超过12个月，7例患者肌力提高到Ⅴ级，缓解率为100%，1例患者肌力提高到Ⅳ级，缓解率为80%。神经根型、脊髓型颈椎病患者随访12 - 36个月，15例患者肌力均有不同程度改善，术后6个月15例患者肌力从术前Ⅱ - Ⅳ级提高到术后Ⅲ - Ⅴ级，缓解率为20% - 100%，15例患者均随访超过12个月，11例患者肌力提高到Ⅴ级，缓解率为100%，3例患者肌力提高到Ⅳ级，缓解率为20% - 50%，1例患者肌力无变化。
脊髓型颈椎病性肌萎缩是一种少见的颈椎病类型，易与运动神经元病混淆而误诊。MRI及肌电图有助于诊断。脊髓型颈椎病性肌萎缩的机制可能是脊髓前角受压或脊髓缺血损伤。手术治疗有助于改善肌力，单节段预后优于多节段。
