颈椎病C3 - C4节段手术病例的临床研究

Clinical study of C3-C4 level surgical cases of cervical spondylosis.

作者信息

Tomii Masato, Mizuno Junichi, Itoh Yasunobu, Watanabe Kazuo

机构信息

Department of Neurosurgery, Southern TOHOKU General Hospital, Iwanuma, Miyagi, Japan.

出版信息

Clin Neurol Neurosurg. 2015 Aug;135:11-4. doi: 10.1016/j.clineuro.2015.04.026. Epub 2015 May 14.

DOI:10.1016/j.clineuro.2015.04.026

PMID:26005164

Abstract

OBJECTIVE

The purpose of this study was to elucidate the pathological characteristics of C3-C4 cervical spondylotic myelopathy (CSM).

METHODS

Single-level anterior cervical discectomy and fusion (ACDF) was performed at C3-C4 in 53 patients (38 men, 15 women). The mean duration of preoperative symptoms was 6.0 months. Fifty-three non C3-C4 ACDF patients of our random sample of ACDF patients were compared to the C3-C4 ACDF patients. Clinical outcomes were assessed according to the Japanese Orthopedic Association score (JOA score), the Neurosurgical Cervical Spine Scale (NCSS), and the Nurick scale. And radiological findings including C2-C7 lordosis, C3-C4 range of intervertebral motion (ROM), C2-C7 ROM, and C3-C4%ROM in the cervical spine were evaluated in both groups.

RESULTS

The recovery rates of JOA score and the NCSS in C3-C4 ACDF patients were 62.5% and 62.1%, respectively. The radiological study of C3-C4 ACDF patients showed that they had significant cervical lordosis, and cervical motion was dependent on the C3-C4 segment, which accounted for 39.8% of C2-C7 ROM (total motion).

CONCLUSION

In C3-C4 ACDF patients, not only static factors, but dynamic factors (instability) at the C3-C4 level contributed to the major causes of CSM.

摘要

目的

本研究旨在阐明C3 - C4节段颈椎病性脊髓病（CSM）的病理特征。

方法

对53例患者（38例男性，15例女性）在C3 - C4节段进行单节段颈椎前路椎间盘切除融合术（ACDF）。术前症状的平均持续时间为6.0个月。将53例接受C3 - C4 ACDF手术的患者与我们随机抽取的非C3 - C4 ACDF手术的ACDF患者进行比较。根据日本骨科协会评分（JOA评分）、神经外科颈椎量表（NCSS）和努里克量表评估临床结果。并对两组患者颈椎的C2 - C7前凸、C3 - C4椎间活动度（ROM）、C2 - C7 ROM以及C3 - C4节段占颈椎ROM的百分比（C3 - C4%ROM）等影像学表现进行评估。