软性颈椎间盘突出症所致脊髓病：手术结果及预后因素
Myelopathy caused by soft cervical disc herniation : surgical results and prognostic factors.
作者信息
Kim Young-Jin, Oh Seong-Hoon, Yi Hyeong-Joong, Kim Young-Soo, Ko Yong, Oh Suck Jun
机构信息
Department of Neurosurgery , Dankook University, College of Medicine, Cheonan, Korea.
出版信息
J Korean Neurosurg Soc. 2007 Dec;42(6):441-5. doi: 10.3340/jkns.2007.42.6.441. Epub 2007 Dec 20.
OBJECTIVE
The purpose of this study was to investigate the surgical results and prognostic factors for patients with soft cervical disc herniation with myelopathy.
METHODS
During the last 7 years, 26 patients with cervical discogenic myelopathy were undertaken anterior discectomy and fusion. Clinical and radiographic features were reviewed to evaluate the surgical results and prognostic factors. The clinical outcome was judged using two grading systems (Herkowitz's scale and Nurick's grade).
RESULTS
Male were predominant (4:1), and C5-6 was the most frequently involved level. Gait disturbance, variable degree of spasticity, discomfort in chest and abdomen, hand numbness were the most obvious signs. Magnetic resonance(MR) images showed that central disc herniation was revealed in 16 cases, and accompanying cord signal changes in 4. Postoperatively, 23 patients showed favorable results (excellent, good and fair) according to Herkowitz's scale.
CONCLUSION
Anterior cervical discectomy and fusion effectively reduced myelopathic symptoms due to soft cervical disc herniation. The authors assured that the shorter duration of clinical attention, the lesser the degree of myelopathy and better outcome in discogenic myelopathy.
目的
本研究旨在探讨软性颈椎间盘突出症合并脊髓病患者的手术效果及预后因素。
方法
在过去7年中，对26例颈椎间盘源性脊髓病患者进行了前路椎间盘切除及融合术。回顾临床和影像学特征以评估手术效果及预后因素。使用两种分级系统（赫科维茨量表和努里克分级）判断临床结果。
结果
男性居多（4:1），C5-6是最常受累节段。步态障碍、不同程度的痉挛、胸腹部不适、手部麻木是最明显的体征。磁共振（MR）图像显示，16例为中央型椎间盘突出，4例伴有脊髓信号改变。术后，根据赫科维茨量表，23例患者显示出良好的结果（优、良和可）。
结论
颈椎前路椎间盘切除及融合术有效减轻了软性颈椎间盘突出症所致的脊髓病症状。作者确信，临床关注时间越短，椎间盘源性脊髓病的脊髓病程度越轻，预后越好。
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