Keller A, von Ammon K, Klaiber R, Waespe W
Neurologische und Neurochirurgische Klinik, Universitätsspitals Zürich.
Schweiz Med Wochenschr. 1993 Sep 11;123(36):1682-91.
The symptoms and signs of spondylotic cervical myelopathy (SCM) in the elderly are variable, but an ataxic-spastic gait disturbance combined with tingling in the finger tips and clumsy hands are often encountered. SCM is due to degenerative changes of discs and osseous and ligamentous structures with compression of the spinal cord. The symptoms, signs, surgical and conservative treatment, and outcome were retrospectively analyzed in 36 patients. Most of the patients undergoing surgery (n = 22) improved their clinical score and maintained this improvement for the period of observation; the non-operated patients (n = 14) had a very slow progression. Diagnostic difficulties and problems of the surgical and conservative approaches are discussed.
老年脊髓型颈椎病(SCM)的症状和体征各不相同,但共济失调 - 痉挛性步态障碍合并指尖刺痛和手部笨拙的情况较为常见。SCM是由椎间盘、骨骼和韧带结构的退行性改变以及脊髓受压引起的。对36例患者的症状、体征、手术及保守治疗情况和结果进行了回顾性分析。大多数接受手术的患者(n = 22)临床评分有所改善,并在观察期内保持了这种改善;未接受手术的患者(n = 14)病情进展非常缓慢。文中还讨论了诊断难点以及手术和保守治疗方法存在的问题。