朱继超;刘宝戈;王磊;麻松;崔维;朱迪;张舵;

• 1:首都医科大学附属北京天坛医院

摘要(Abstract)：

[目的]探讨平山病患者颈椎前路手术治疗初步效果及平山病的手术缓解机制。[方法]回顾性分析2012年11月~2016年5月接受颈椎前路手术治疗且资料完整的平山病患者13例,所有患者经神经内科确诊,并除外运动神经元疾病,且保守治疗无效,病情持续进展严重影响患者生活质量。其中10例采用颈椎前路单纯钛板螺钉内固定术,3例因存在明显颈椎间盘退变突出,采用颈椎前路ACDF手术治疗。采用改良JOA评分评价术前和末次随访时神经功能,此外,测量患者颈椎后突(C2~7Cobb角),颈椎活动度(ROM)、颈椎最大屈曲角度(MFA)。[结果]所有患者随访7~49个月,平均32.7±15个月。末次随访时,术后伸指震颤症状减轻,但症状未完全消失;肌肉萎缩症状改善不明显。改良JOA评分由术前的(12.85±1.70)增加至末次随访时的(14.38±1.46),差异有统计学意义(P=0.021)。术后屈曲位颈椎MRI可以观察到脊髓前方压迫缓解,并有局部脊髓膨胀表现。术前与末次随访时相比较,C2~7Cobb角[(10.69±11.12)°vs(8.08±8.14)°,P=0.50]差异无统计学意义;但颈椎活动度[(71.92±15.65)°vs(37.69±11.18)°,P<0.001]和颈椎最大屈曲角度[(37.08±6.80)°vs(20.15±8.65),P<0.001]显著减少,差异有统计学意义。[结论]颈椎前路内固定或融合手术能够限制平山病患者颈椎过度前屈,从而减少颈椎活动时脊髓前侧的反复撞击,减缓甚至停止上肢远端肌萎缩的进展。

关键词(KeyWords)： 平山病;颈椎前路手术;手术疗效

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金资助项目(编号:81472137);; 北京市自然科学基金资助项目(编号:7162058);; 北京市卫生系统高层次卫生技术人才资助项目(2014-3-034)

作者(Author): 朱继超;刘宝戈;王磊;麻松;崔维;朱迪;张舵;

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