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[颈椎管狭窄症——症状性椎管狭窄和神经根管狭窄的诊断与治疗]

[Cervical stenosis-Diagnostics and treatment of symptomatic spinal canal stenosis and neuroforaminal stenosis].

作者信息

Begrich Daniel, Jäger Marcus

机构信息

Wirbelsäulenzentrum, St. Marien Hospital Mülheim a.d.R., Kaiserstr. 50, 45468, Mülheim, Deutschland.

Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Aug;53(8):617-628. doi: 10.1007/s00132-024-04526-2. Epub 2024 Jul 8.


DOI:10.1007/s00132-024-04526-2
PMID:38976023
Abstract

Cervical stenosis is a clinical picture that is regularly encountered by both hospital physicians and orthopedic surgeons in the daily clinical practice. While advanced cervical spinal canal stenosis may lead to myelopathic symptoms in cases of sufficient manifestation and spinal cord injury, neuroforaminal stenosis leads to radicular symptoms due to compression of the nerve roots. The clinical examination can provide initial clues as to the suspected cause of the patient's symptoms; however, reliable diagnostics are based only on sectional imaging of the cervical spine. Depending on the extent of the symptoms, the treatment options vary between nonsurgical treatment for moderate symptoms without neurological deficits and surgical decompression of the spinal cord or nerve roots. The surgical treatment can be performed from anterior or posterior depending on the findings. Surgery can lead to an improvement of the neurological symptoms; however, the primary aim of surgical treatment is to avoid deterioration of the neurological deficits.

摘要

颈椎管狭窄是医院医生和骨科医生在日常临床实践中经常遇到的一种临床表现。虽然严重的颈椎管狭窄在表现充分且脊髓损伤的情况下可能导致脊髓病症状,但神经孔狭窄由于神经根受压会导致神经根症状。临床检查可以为患者症状的疑似病因提供初步线索;然而,可靠的诊断仅基于颈椎的断层成像。根据症状的严重程度,治疗选择在无神经功能缺损的中度症状的非手术治疗与脊髓或神经根的手术减压之间有所不同。根据检查结果,手术治疗可从前路或后路进行。手术可改善神经症状;然而,手术治疗的主要目的是避免神经功能缺损的恶化。

相似文献

[1]
[Cervical stenosis-Diagnostics and treatment of symptomatic spinal canal stenosis and neuroforaminal stenosis].

Orthopadie (Heidelb). 2024-8

[2]
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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013-4

[3]
Frequency, timing, and predictors of neurological dysfunction in the nonmyelopathic patient with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament.

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[5]
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[6]
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[7]
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J Bone Joint Surg Br. 2012-3

[8]
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J Nucl Med. 2011-8-18

[9]
One-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis on cervical and lumbar spine: analyses of clinical outcomes with minimum 3 years follow-up.

J Spinal Disord Tech. 2009-12

[10]
Cervical stenosis in adults undergoing thoracolumbar deformity surgery: incidence, treatment, and complications: clinical article.

J Neurosurg Spine. 2013-7-26

本文引用的文献

[1]
Clinical and Research MRI Techniques for Assessing Spinal Cord Integrity in Degenerative Cervical Myelopathy-A Scoping Review.

Biomedicines. 2022-10-18

[2]
7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging.

Invest Radiol. 2021-11-1

[3]
The Effectiveness of Fluoroscopically Guided Cervical Transforaminal Epidural Steroid Injection for the Treatment of Radicular Pain; a Systematic Review and Meta-analysis.

Pain Med. 2020-1-1

[4]
Development and Implementation of Clinical Practice Guidelines: An Update and Synthesis of the Literature With a Focus in Application to Spinal Conditions.

Global Spine J. 2019-5

[5]
Guidelines for the Management of Degenerative Cervical Myelopathy and Acute Spinal Cord Injury: Development Process and Methodology.

Global Spine J. 2017-9

[6]
A Clinical Practice Guideline for the Management of Patients With Degenerative Cervical Myelopathy: Recommendations for Patients With Mild, Moderate, and Severe Disease and Nonmyelopathic Patients With Evidence of Cord Compression.

Global Spine J. 2017-9

[7]
Tandem Spinal Stenosis: A Systematic Review.

JBJS Rev. 2017-9

[8]
Comparison of inter- and intra-observer reliability among the three classification systems for cervical spinal canal stenosis.

Eur Spine J. 2017-9

[9]
[Clinical and Radiological Results after Anterior Cervical Corpectomy with Cage Fusion - a Retrospective Comparison of PEEK vs. Titanium Cages].

Z Orthop Unfall. 2017-4

[10]
The Significance of the Trömner Sign in Cervical Spondylotic Myelopathy Patient.

Clin Spine Surg. 2017-11

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