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颈椎病性脊髓压迫症患者发生脊髓病的危险因素。

Risk factors for development of myelopathy in patients with cervical spondylotic cord compression.

作者信息

Matsunaga Shunji, Komiya Setsuro, Toyama Yoshiaki

机构信息

Department of Orthopaedic Surgery, Imakiire General Hospital, 4-16 Shimotatsuo chou, Kagoshima, 892-8502, Japan,

出版信息

Eur Spine J. 2015 Apr;24 Suppl 2:142-9. doi: 10.1007/s00586-013-2839-9. Epub 2013 May 23.

Abstract

PURPOSE

To clarify risk factors for the development of myelopathy in patients with cervical spondylotic cord compression.

METHOD

The authors reviewed articles in which risk factors for the development of myelopathy in patients with cervical spondylotic cord compression were discussed. Ossification of the posterior longitudinal ligament (OPLL) was also reviewed as a disease which causes cervical cord compression to clarify pathomechanism of the development of myelopathy.

RESULTS

Cervical motion segment disorders are considered to be multifactorial, and developmental size of the canal and foramina, pathological encroachment, biomechanical effects, and circulatory deficiencies are always present to some degree. Static and dynamic factors should be considered for the development of myelopathy. To clarify the pathomechanism of the development of myelopathy in patients with cervical spondylotic spinal cord compression, the exact natural history of CSM should be understood.

CONCLUSION

Several predictable risk factors for the development of myelopathy have been proposed in CSM or OPLL studies, but they were not definitive. Further prospective population-based study is needed to clarify the mechanism.

摘要

目的

明确脊髓型颈椎病患者发生脊髓病的危险因素。

方法

作者回顾了讨论脊髓型颈椎病患者发生脊髓病危险因素的文章。还对后纵韧带骨化(OPLL)这一导致颈髓受压的疾病进行了回顾,以阐明脊髓病发生的病理机制。

结果

颈椎运动节段紊乱被认为是多因素的,椎管和椎间孔的发育大小、病理侵犯、生物力学效应和循环不足在一定程度上总是存在的。脊髓病的发生应考虑静态和动态因素。为阐明脊髓型颈椎病脊髓受压患者脊髓病发生的病理机制,应了解CSM的确切自然病程。

结论

在CSM或OPLL研究中已提出了几种脊髓病发生的可预测危险因素,但并不明确。需要进一步开展基于人群的前瞻性研究以阐明其机制。

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