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变革性的缓解方法:颈椎间盘置换术挽救伴有神经功能缺损的神经根型颈椎病

Revolutionizing Relief: Cervical Radiculopathy With Neurological Deficits Rescued by Cervical Disc Replacement.

作者信息

Singh Rahul, Khan Sohael, Ambade Ratnakar E, Kanani Kashyap, Agrawal Vipul, Patel Siddharth K

机构信息

Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Department of Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 May 8;16(5):e59923. doi: 10.7759/cureus.59923. eCollection 2024 May.

Abstract

Cervical radiculopathy is a common condition characterized by neck pain radiating to the upper and lower limbs, often accompanied by tingling sensations, numbness, and weakness. We present the case of a 32-year-old male who presented with left-sided cervical radiculopathy and neurological deficits. Clinical examination revealed left C5/C6/C7 hypoesthesia, diminished grip strength, reduced power in the left upper and lower extremities, and a positive Spurling test. Magnetic resonance imaging (MRI) of the cervical spine revealed multilevel cervical disc herniations at C4-C5 and C5-C6 levels, resulting in stenosis. The patient underwent anterior cervical discectomies with artificial disc replacement (cervical disc arthroplasty (CDA)) at the C5-C6 level. The surgical procedure was uneventful, and the patient experienced prompt relief from neurological symptoms within two weeks postoperatively. Follow-up radiographs at one week post-surgery demonstrated a preserved range of motion at each operated level with the artificial disc in situ. This case highlights the successful management of cervical radiculopathy with neurological deficits using anterior cervical discectomy and artificial disc replacement. The timely intervention led to the resolution of symptoms and restoration of function, demonstrating the efficacy of this surgical approach in alleviating radicular symptoms and preserving cervical spine mobility. Further studies and long-term follow-up are warranted to validate the long-term outcomes and durability of artificial disc replacement in such cases.

摘要

神经根型颈椎病是一种常见病症,其特征为颈部疼痛放射至上下肢,常伴有刺痛感、麻木和无力感。我们报告一例32岁男性患者,其表现为左侧神经根型颈椎病及神经功能缺损。临床检查发现左侧C5/C6/C7感觉减退、握力减弱、左上肢和下肢肌力下降,以及Spurling试验阳性。颈椎磁共振成像(MRI)显示C4 - C5和C5 - C6水平存在多节段颈椎间盘突出,导致椎管狭窄。该患者在C5 - C6水平接受了前路颈椎间盘切除并人工椎间盘置换术(颈椎间盘置换术(CDA))。手术过程顺利,患者术后两周内神经症状迅速缓解。术后一周的随访X线片显示,各手术节段人工椎间盘在位,活动度良好。本病例突出了采用前路颈椎间盘切除和人工椎间盘置换术成功治疗伴有神经功能缺损的神经根型颈椎病。及时干预使症状得到缓解,功能得以恢复,证明了这种手术方法在缓解神经根症状和保留颈椎活动度方面的有效性。有必要进行进一步研究和长期随访,以验证此类病例中人工椎间盘置换的长期疗效和耐用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbf6/11161573/4aed4fbaccec/cureus-0016-00000059923-i01.jpg

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