Gumina Stefano, Candela Vittorio, Passaretti Daniele, Villani Ciro
Department of Orthopaedics and Traumatology, Shoulder and Elbow Unit, Sapienza, University of Rome, Rome, Italy.
Int Orthop. 2018 Jan;42(1):157-160. doi: 10.1007/s00264-017-3593-0. Epub 2017 Aug 10.
To evaluate if herpes zoster virus (HZV) reactivation may be considered in the aetiology of cervical radiculopathy.
The study group was composed of 110 patients (52 M-58F;mean age ± SD:46.5 ± 6.12; range:40-73) with a clinical diagnosis of cervical radiculopathy. Patients with signs of chronic damage on neurophysiological studies were submitted to an X-ray and to an MRI of the cervical spine in order to clarify the cause of the cervical radiculopathy and were investigated for a possible reactivation of HZV; HZV reactivation was considered as "recent" or "antique" if it occurs within or after 24 months from the onset of symptoms, respectively. Data were submitted to statistics.
Thirty-eight patients (34,5%,16 M-22F) had a history of HZV reactivation: four (2 M-2F) were "recent" and 34 (14 M-20F) were "antique". In 68 of 110 participants (61,8%,30 M-38F), pathological signs on X-ray and/or MRI of the cervical spine appeared; in the remaining 42 (38,2%,22 M-20F) X-ray and MRI resulted as negative. Among patients with HZV reactivation, seven (18,4%) had a "positive" X-ray-MRI while in 31 (81,6%) the instrumental exams were considered as negative. The prevalence of "antique" HZV reactivations was statistically greater in the group of patients with no pathological signs on X-ray/MRI of the cervical spine with respect to the group with a pathological instrumental exam (p < 0.01).
It may be useful to investigate the presence of a positive history of HZV reactivation and to consider it as a long-term complication of a cervical root inflammation especially in patients in which X-ray and MRI of the cervical spine did not show pathological findings.
评估带状疱疹病毒（HZV）再激活是否可被视为神经根型颈椎病病因之一。
研究组由110例临床诊断为神经根型颈椎病的患者组成（52例男性 - 58例女性；平均年龄±标准差：46.5±6.12；范围：40 - 73岁）。神经生理学研究有慢性损伤体征的患者接受颈椎X线和MRI检查，以明确神经根型颈椎病的病因，并调查HZV是否可能再激活；如果HZV再激活分别在症状出现后24个月内或24个月后发生，则被视为“近期”或“陈旧性”。数据进行统计学分析。
38例患者（34.5%，16例男性 - 22例女性）有HZV再激活病史：4例（2例男性 - 2例女性）为“近期”，34例（14例男性 - 20例女性）为“陈旧性”。110名参与者中有68例（61.8%，30例男性 - 38例女性）颈椎X线和/或MRI出现病理体征；其余42例（38.2%，22例男性 - 20例女性）X线和MRI结果为阴性。在HZV再激活的患者中，7例（18.4%）X线 - MRI“阳性”，而31例（81.6%）影像学检查被视为阴性。颈椎X线/MRI无病理体征的患者组中“陈旧性”HZV再激活的患病率在统计学上高于影像学检查有病理表现的组（p < 0.01）。
调查HZV再激活阳性病史并将其视为神经根炎症的长期并发症可能是有用的，特别是在颈椎X线和MRI未显示病理结果的患者中。
