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颈神经根病:聚焦于特征与鉴别诊断

Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis.

作者信息

Kang Kyung-Chung, Lee Hee Sung, Lee Jung-Hee

机构信息

Department of Orthopedic Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Asian Spine J. 2020 Dec;14(6):921-930. doi: 10.31616/asj.2020.0647. Epub 2020 Dec 22.

Abstract

Cervical radiculopathy is characterized by neurological dysfunction caused by compression and inflammation of the spinal nerves or nerve roots of the cervical spine. It mainly presents with neck and arm pain, sensory loss, motor dysfunction, and reflex changes according to the dermatomal distribution. The most common causes of cervical radiculopathy are cervical disc herniation and cervical spondylosis. It is important to find the exact symptomatic segment and distinguish between conditions that may mimic certain cervical radicular compression syndromes through meticulous physical examinations and precise reading of radiographs. Non-surgical treatments are recommended as an initial management. Surgery is applicable to patients with intractable or persistent pain despite sufficient conservative management or with severe or progressive neurological deficits. Cervical radiculopathy is treated surgically by anterior and/or posterior approaches. The appropriate choice of surgical treatment should be individualized, considering the patient's main pathophysiology, specific clinical symptoms and radiographic findings thoroughly.

摘要

颈椎神经根病的特征是由颈椎的脊神经或神经根受压和炎症引起的神经功能障碍。根据皮节分布,其主要表现为颈部和手臂疼痛、感觉丧失、运动功能障碍以及反射改变。颈椎神经根病最常见的病因是颈椎间盘突出症和颈椎病。通过细致的体格检查和精确解读影像学检查结果,找出确切的症状节段并区分可能模拟某些颈椎神经根受压综合征的情况非常重要。非手术治疗被推荐作为初始治疗方法。对于尽管经过充分的保守治疗仍有顽固性或持续性疼痛,或有严重或进行性神经功能缺损的患者,可考虑手术治疗。颈椎神经根病通过前路和/或后路手术进行治疗。应根据患者的主要病理生理学、具体临床症状和影像学检查结果,对手术治疗进行个体化的合理选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d75/7788378/f5a29577a68a/asj-2020-0647f1.jpg

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