摘要
目的 :对痉挛性脑瘫患者合并颈脊髓病的原因、诊断、治疗及疗效进行临床研究。方法 :对 16例痉挛性脑瘫患者出现的颈脊髓病 ,就其发生机制、X线特点、临床表现、诊断、治疗及疗效进行了研究。结果 :痉挛性脑瘫患者由于颈部肌肉的不随意运动 ,致颈椎过度活动 ,加重颈椎退变 ,因此在其青少年时期即易发生颈椎不稳、椎间盘突出、骨赘形成、扁平椎及发育性颈椎管狭窄等变化。上述病理改变导致颈脊髓病的发生。由于其颈椎退变的特殊性及颈椎不稳的持续性 ,对其手术不仅要求彻底减压 ,更强调对颈椎的稳定。本组 11例 ,在Halo氏架固定下行颈后路单开门椎管扩大成型术及门轴侧椎板间植骨术 ,术后行Halo氏架固定 3个月。术后随访平均 5年 8个月 ,其中优 4例 ,良 4例 ,可 3例 ,优良率 72 .7%。结论 :痉挛性脑瘫患者在青少年时期即出现颈椎退行性变 ,导致颈脊髓病发生。手术治疗不仅要求彻底减压 ,更强调对颈椎的稳定。
Objective:To study clinically the causes?diagnosis?surgical treatment and operative result of cervical myelopathy secondary to athetoid cerebral palsy.Methods:Sixteen cases of cervical myelopathy secondary to athetoid cerebral palsy were studied on the pathomechanism of cervical myelopathy,radiographic findings,clinical manifestations,diagnosis,surgical treatment and operative result.Results:Instability,disc protrustion,osteophyte,flatten vertebra and developmental canal stenosis of cervical spine occurred at a young age in the patients with athetoid cerebral palsy.Above pathological changes caused the cervical myelopathy of the patients with athetoid cerebral palsy.The purpose of the surgery is not only to decompress the involved neural elements but also to emphasize the stability of cervical spine.In this group,11 cases had undergone the operation of expensive open-door laminoplasty and bone chip grafting to lateral bony gutter at C_ 3～7 applied halo-vest fixation.Halo-vest fixation was applied for 3 months postoperatively.Averaged follow-up period were 5 years and 8 months.Of the 11 cases,4 cases had excellent results,4 had good results and 3 had fair results.The percentage of excellent and good results was 72.7%.Conclusion:Cervical degenerative changes occur at a young age in the patients with athetoid cerebtal palsy,and these changes can cause cervical myelopathy.Surgical treatment is not only to decompress the involved neural elements but also to emphasize the stability of cervical spine.
出处
《中国矫形外科杂志》
CAS
CSCD
2003年第8期518-520,共3页
Orthopedic Journal of China
关键词
痉挛性脑瘫
颈脊髓病
诊断
手术治疗
Athetoid cerebral palsy
Cervical myelopathy
Diagnosis
Surgical treatment
