摘要
目的:探讨青年颈椎病的发病特点及手术治疗效果。方法:2002年1月～2007年6月在我院住院治疗的30岁以下的颈椎病患者30例,男26例,女4例;农民5例,工人4例,办公室职员11例,学生2例,无固定职业7例,杂技演员1例。发病至手术时间1～36个月,平均10个月。回顾分析其发病过程、临床表现、治疗经过,根据JOA17分评分或VAS评分标准随访治疗效果。结果:手术治疗的青年颈椎病患者占同期颈椎病手术治疗病例的0.75%。脊髓型24例,神经根型2例,脊髓型合并交感型4例。伏案工作者占43%,合并发育性椎管狭窄10例,椎间盘退变27例,颈椎不稳2例。前路减压融合固定11例,前路减压人工椎间盘置换9例;后方入路C3～C7单开门椎管扩大成形术6例;前后联合手术4例。1例术后出现C5神经根麻痹症状,3d后缓解,未发生其他手术相关并发症。所有患者术后症状均明显改善,脊髓型患者JOA评分由13分提高到16.7分,改善率为93%;神经根型患者VAS评分由8分改善到0分,改善率为100%。平均随访34个月,均恢复原工作,行椎间融合者未发生内固定松动脱落断裂及固定相关并发症,椎间盘置换者未出现内置物松动脱落及相关并发症,1例出现轻度头晕,但不影响工作。结论:青年颈椎病多发于长期伏案工作人群,椎间盘退变突出和发育性椎管狭窄是主要致病因素,针对致病因素采取前路椎间盘切除减压椎间融合或非融合或/和后路椎板成形术可取得满意疗效。
Objective：To study the characteristics of cervical spondylosis and the effects of surgical treatment in the patients under 30 years old.Method：The medical records of all cases under 30 years old who underwent surgical treatment for cervical spondylosis from January 1,2002 to June 30,2007 were analyzed retrospectively,which included pathogenesis,elinieal manifestations,treatment and follow-up according to the scale of Japanese Orthopaedic Association（JOA）.30 cases were enrolled with 26 males and 4 females,Among them, there were 5 farmers,4 physical workers, 11 office workers,2 students ,7 without regular work and 1 acrobat. The interval time between the onset of the disease to the operation was1-36 months,with an average of 10 months.Result：Those with cervical spondylosis under 30 years old who underwent surgical treatment accounted for 0.8% of all cases of cervical spondylosis treated surgically in the same period,including myelopathy 24 eases,radieulopathy 2 eases,myelopathy combined with sympathetic symptoms 4 eases.Office worker was 43% in this group, 10 cases with developmental stenosis of vertebral canal,27 cases with degeneration of intervertebral disc,2 cases with intervertebral instability of cervical spine.The surgical procedures included anterior decompression and fusion in 11 cases,artificial intervertebral disc replacement 9 eases,C3-7 posterior opendoor laminoplasty 6 cases,combined anterior and posterior operation 4 cases.C5 nerve root palsy occurred in 1 case after posterior open-door laminoplasty,but it recovered 3 days after surgery.There was no other surgical related complications.30 cases were followed up for 12-72 months,with an average of 34 months.The symptoms fo all patients were markedly improved postoperatively, the JOA scales of myelopathy type incerased from pre-operatve13 （range,10-15） to postoperative 16.7 （range, 16-17）, and the improvement rate was 93%.The Visual Analogue Scale of radiculopathy type decreased from 8 to 0 with 100% of improvement rate.No complication related to either intervertebral fixation and fusion or artificial intervertebral disc replacement occurred in this group,except 1 case with dizziness.Conclusion：Cervical spondylosis in youths under 30 years old mainly occurs in the people with office work,the major etiological factors are intervertebal disc degeneration and canal stenosis,a good outcome can be obtained by anterior discectomy with fusion or non-fusion and/or posterior laminoplasty.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2009年第2期117-120,共4页
Chinese Journal of Spine and Spinal Cord
关键词
颈椎病
椎间盘
外科治疗
青年
Cervical spondylosis
Intervertebral disc
Operation
Youth
