Epstein J A, Epstein B S, Lavine L S, Carras R, Rosenthal A D
J Neurosurg. 1978 Sep;49(3):387-92. doi: 10.3171/jns.1978.49.3.0387.
Five patients with typical cervical myeloradiculopathy caused by focal cervical spinal stenosis are presented. Dorsal intrusions into the spinal canal by hypertrophied apophyseal joints and thickened laminae resulted in cord and nerve root compression. Minor spondylotic changes were present in the floor of the spinal canal. Laminar decompression with formainotomy and facetectomy relieved the patients of their symptoms. An anterior approach should not be considered in the management of this disorder. Our findings of severe apophyseal arthrosis with lesser degrees of associated spondylosis are similar to those described in anatomical studies by other authors. While uncommon, myelopathy caused by dorsal compression of the spinal cord and nerve roots deserves specific mention so that therapy can be directed to the proper quadrants of the spinal canal wherein the significant pathology is located.
本文介绍了5例因颈椎管狭窄导致典型脊髓神经根型颈椎病的患者。肥大的关节突关节和增厚的椎板向椎管内背侧突出,导致脊髓和神经根受压。椎管底部存在轻度的脊柱退变改变。行椎板减压、椎间孔切开术和关节突切除术缓解了患者的症状。对于这种疾病的治疗,不应考虑前路手术。我们发现严重的关节突关节病合并较轻程度的脊柱退变,这与其他作者在解剖学研究中描述的情况相似。虽然不常见,但脊髓和神经根背侧受压引起的脊髓病值得特别提及,以便针对椎管内存在明显病变的相应象限进行治疗。