摘要
目的探讨脊髓型颈椎病（ＣＳＭ）早期诊断的可能性，筛选预示ＣＳＭ发作的临床、影像学及电生理指标。方法根据ＣＳＭ常见特征，选择２９项与ＣＳＭ发病有关的指标并据此建立研究对象的入选标准。对８１例符合预选指标的患者进行２～６５年（平均３７年）的随访追踪观察。手术组与非手术组的各项指标行对照研究。结果有上肢疼痛、感觉异常、肢体动作灵活性丧失、动态Ｈｏｆｍａｎｎ征阳性、发育性椎管狭窄、颈椎不稳、颈椎间盘突出、中枢运动传导时间延迟等１３项指标与ＣＳＭ发病密切相关。２９例演变为ＣＳＭ并行早期手术处理，术后疗效良好。结论通过对有临床可疑指标者密切观察和随访，颈椎病的早期诊断是可能的；对其中出现神经损害征象者，宜及早手术以避免对神经功能产生不可逆性损害；
Objective To probe into the possibility of early diagnosis of cervical spondylotic myelopathy (CSM) prospectively and to screen the premorbid signs of CSM clinically, radiologically and electro physiologically. Method Twenty nine items related to the occurring of CSM were chosen as common characteristics of CSM and considered as the criteria of prospective study. 81 patients who met the criteria were studied. All patients were followed up and observed for 2～6 5 years (mean 3 7 years). Result Twenty nine patients showed CSM during investigation. Thirteen items of the criteria were related to the occurring of CSM. The significant items include upper limb pain and abnormal sensation limb numbness, positive dynamic Hoffmann′s sign, cervical canal stenosis, lower cervical instability, cervical intervertebral disc herniation, and delay of central motor conduct time. Conclusion CSM can be early diagnosed. The patients who meet the established criteria should be followed up and observed closely. Early operation results in good effect.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第12期717-720,共4页
Chinese Journal of Surgery
关键词
诊断
前瞻性
颈椎病
脊髓型
早期诊断
Spinal cord compression Cervical vertebrace Diagnosis Prospective studies
