Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Aichi, Japan.
Spine (Phila Pa 1976). 2012 Oct 15;37(22):E1383-8. doi: 10.1097/BRS.0b013e3182684c68.
A retrospective single-center study.
To investigate the prevalence of symptoms before and after surgery in a large series of patients with cervical spondylotic myelopathy (CSM).
No study has elucidated the epidemiological data regarding the prevalence of pre- and postoperative symptoms in patients with CSM.
Five hundred twenty consecutive patients with CSM (331 male and 189 female; mean age, 62.2 yr) treated by laminoplasty were enrolled. The average follow-up period was 33.3 months. Severity of myelopathy was evaluated according to a scoring system proposed by the Japanese Orthopedic Association for CSM, and prevalence was determined by the presence or absence of a full Japanese Orthopedic Association score for each function. The persistence rate (%) (postoperative prevalence/preoperative prevalence × 100) of each function impairment was also assessed after surgery.
The preoperative prevalence of motor function impairment in the upper and lower extremities was 77.7% and 80.4%, respectively, whereas that of sensory function impairment in the upper and lower extremities and trunk was 88.6%, 56.5%, and 48.3%, respectively. The preoperative prevalence of urinary bladder function impairment was 41.2%. The persistence rate of motor function impairment in the upper and lower extremities was 52.7% and 71.5%, respectively, whereas that of sensory function impairment in the upper and lower extremities and trunk was 72.0%, 56.8%, and 61.4%, respectively. The persistence rate of urinary bladder function impairment was 49.1%.
The preoperative prevalence of motor function impairment in the upper and lower extremities and that of sensory function impairment in the upper extremity is higher than that of other function impairments, and impairments in lower extremity motor function and upper extremity sensory function often persist after surgery. These findings provide baseline data that may allow clinicians to accurately assess preoperative impairment and postoperative outcomes in patients with CSM.
回顾性单中心研究。
在一大组颈椎病患者中研究手术前后症状的发生率。
目前还没有研究阐明颈椎病患者手术前后症状发生率的流行病学数据。
纳入 520 例接受颈椎板成形术治疗的颈椎病患者（331 例男性，189 例女性；平均年龄 62.2 岁）。平均随访时间为 33.3 个月。根据日本矫形协会提出的颈椎病评分系统评估脊髓病的严重程度，根据每个功能是否存在完整的日本矫形协会评分来确定患病率。还评估了手术后每个功能障碍的持续率（%（术后患病率/术前患病率×100）。
上肢和下肢运动功能障碍的术前患病率分别为 77.7%和 80.4%，而上肢和下肢及躯干感觉功能障碍的术前患病率分别为 88.6%、56.5%和 48.3%。术前膀胱功能障碍的患病率为 41.2%。上肢和下肢运动功能障碍的持续率分别为 52.7%和 71.5%，而上肢和下肢及躯干感觉功能障碍的持续率分别为 72.0%、56.8%和 61.4%。膀胱功能障碍的持续率为 49.1%。
上肢和下肢运动功能障碍以及上肢感觉功能障碍的术前患病率高于其他功能障碍，下肢运动功能障碍和上肢感觉功能障碍常持续存在术后。这些发现提供了基线数据，使临床医生能够准确评估颈椎病患者的术前损伤和术后结果。
