[颈椎减压术后脑瘫病因的研究进展]
[Research progress of etiologies for C palsy after cervical decompression].
作者信息
Guo Chuan, Song Xinyue, Kong Qingquan, Wang Yu, Wu Ye, Li Weilong
机构信息
West China School of Medicine, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Mar 15;36(3):376-379. doi: 10.7507/1002-1892.202111072.
OBJECTIVE
To review the definition and possible etiologies for C palsy.
METHODS
The literature on C palsy at home and abroad in recent years was extensively reviewed, and the possible etiologies were analyzed based on clinical practice experience.
RESULTS
There are two main theories (nerve root tether and spinal cord injury) accounting for the occurrence of C palsy, but both have certain limitations. The former can not explain the occurrence of C palsy after anterior cervical spine surgery, and the latter can not explain that the clinical symptoms of C palsy is often the motor dysfunction of the upper limb muscles. Based on the previous reports, combining our clinical experience and research, we propose that the occurrence of C palsy is mainly due to the instrumental injury of anterior horn of cervical spinal cord during anterior cervical decompression. In addition, the C palsy following surgery via posterior approach may be related to the nerve root tether caused by the spinal cord drift after decompression.
CONCLUSION
In view of the main cause of C palsy after cervical decompression, it is recommended to reduce the compression of the spinal cord by surgical instruments to reduce the risk of this complication.
目的
回顾C瘫的定义及可能的病因。
方法
广泛查阅近年来国内外关于C瘫的文献，并根据临床实践经验分析可能的病因。
结果
有两种主要理论（神经根牵拉和脊髓损伤）解释C瘫的发生，但均有一定局限性。前者无法解释颈椎前路手术后C瘫的发生，而后者无法解释C瘫的临床症状常为上肢肌肉运动功能障碍。基于既往报道，结合我们的临床经验和研究，我们提出C瘫的发生主要是由于颈椎前路减压术中颈脊髓前角的器械损伤。此外，后路手术后发生的C瘫可能与减压后脊髓漂移导致的神经根牵拉有关。
结论
鉴于颈椎减压术后C瘫的主要原因，建议减少手术器械对脊髓的压迫以降低该并发症的风险。
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