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神经根型颈椎病合并脊髓型颈椎病:患病率及特征

Cervical radiculopathy combined with cervical myelopathy: prevalence and characteristics.

作者信息

Choi Byung-Wan, Kim Sung-Soo, Lee Dong-Hyun, Kim Ji-Wan

机构信息

Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University, Haeundae-ro 875, Haeundae-gu, Busan, 612-896, Korea.

出版信息

Eur J Orthop Surg Traumatol. 2017 Oct;27(7):889-893. doi: 10.1007/s00590-017-1972-2. Epub 2017 May 15.

Abstract

Patients with cervical myelopathy may experience symptoms of radiculopathy, and it is not easy to determine whether these symptoms are caused by the myelopathy itself or by a radiculopathy accompanied by root compression. Therefore, we aimed to investigate the prevalence of radiculopathy combined with cervical myelopathy and to evaluate the characteristics of cervical myelopathy with or without radiculopathy. We enrolled 127 patients with cervical myelopathy in this retrospective study and reviewed their medical records and magnetic resonance imaging findings. They were divided into two groups according to the presence of cervical radiculopathy, and their age, sex, involved spinal segment, cord signal change, surgical method, clinical status were compared, and postsurgical recovery was compared using four clinical questionnaires. The incidence and level of radiculopathy combined with myelopathy were investigated. Combined cervical radiculopathy and myelopathy was diagnosed in 66 patients (51.9%, group 1), whereas 61 patients did not have radiculopathy (group 2). There was no difference in sex, age, cord signal change, preoperative Japanese Orthopedic Association score, neck disability index, and neck visual analogue scale (VAS) between the two groups, but group 1 showed higher preoperative arm VAS score (p = 0.001). Postoperative arm and neck VAS scores were significantly improved in group 1 (p = 0.001 and 0.009). Half of the patients had combined cervical myelopathy and radiculopathy. A high preoperative arm VAS score was a characteristic of radiculopathy combined with myelopathy.

摘要

脊髓型颈椎病患者可能会出现神经根病症状,很难确定这些症状是由脊髓病本身引起,还是由伴有神经根受压的神经根病引起。因此,我们旨在调查神经根病合并脊髓型颈椎病的患病率,并评估伴有或不伴有神经根病的脊髓型颈椎病的特征。在这项回顾性研究中,我们纳入了127例脊髓型颈椎病患者,并查阅了他们的病历和磁共振成像结果。根据是否存在颈椎神经根病将他们分为两组,比较两组患者的年龄、性别、受累脊髓节段、脊髓信号变化、手术方式、临床状况,并使用四份临床问卷比较术后恢复情况。调查神经根病合并脊髓病的发病率和程度。66例患者(51.9%,第1组)被诊断为合并颈椎神经根病和脊髓病,而61例患者没有神经根病(第2组)。两组患者在性别、年龄、脊髓信号变化、术前日本矫形外科学会评分、颈部残疾指数和颈部视觉模拟量表(VAS)方面没有差异,但第1组术前上肢VAS评分更高(p = 0.001)。第1组术后上肢和颈部VAS评分显著改善(p = 0.001和0.009)。一半的患者合并颈椎脊髓病和神经根病。术前上肢VAS评分高是神经根病合并脊髓病的一个特征。

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