椎孔外颈神经卡压综合征  

Eexternal Intervertebral Foramen’s Cervical Nerve Compression Syndrome

作　　者：王金武[1] 陈德松[1] 方有生[1] 顾玉东[1] 

机构地区：[1]上海医科大学华山医院手外科,200040

出　　处：《实用骨科杂志》1999年第3期130-132,共3页Journal of Practical Orthopaedics

摘　　要：目的：研究椎孔外颈神经卡压综合征的机制及诊治方法。方法：对５２ 例此类患者进行了详细的临床观察和分析。均先经保守治疗，其中１５ 例行前、中及小斜角肌切断及颈神经松解术。结果：保守治疗近期虽有一定疗效，但不理想。１５ 例术后随访６ 个月～３ 年半，症状消失，均未见复发。其主要症状为头面部、颈肩部疼痛，患侧上肢乏力，嗅觉、味觉减退，无明显外伤史。在胸锁乳突肌后缘的颈椎横突后结节，是颈部明显压痛点的位置。感觉障碍以颈肩部、头面部及上肢刺痛减退为主。 Ｘ 线片示 Ｃ３～ Ｃ７ 颈椎椎体有明显骨质增生４１ 例，椎间隙狭窄２７ 例。结论：椎孔外颈神经卡压综合征的病因是以前、中及小斜角肌为主的颈前肌群和颈后肌群的腱性交叉纤维压迫颈丛、臂丛及颈神经后支所致。Objective:To study mechanism,diagnosis and treatment of the external intervertebral foramen’s cervical nerve compression syndrome.Methods:Detailed observation and analysis was conducted in 52 cases.All the cases had received conservative treatment.Resectin of scalenus anticus,medius and minimus and cervical nerve decompressions were undertaken in 15 cases.Results:Conservative treatment led to short-term alleviation of the symptoms.The result was far from satisfaction.Between six months and three and a half years’ follow up of the 15 surgically treated cases revealed complete elimination of the symptoms without relapse.The characteristics of the clinical entity were pain of the head,face,neck and shoulder;weakness of the involved upper limbs;hyposmia;hypogeusesthesia;no apparent history of trauma.The most obvious tenderness point was the posterior tubercle of the cervicle vertebral transverse process located at the posterior margin of sternoclaidomastoid muscle.Impairment of sensation was menifested as decreased sting at hand,face,neck,shoulder,and upper limb.Roentgenography showed hypertrophy of C3～C5 vertebrae in 41 cases and a narrowing of intervertebral space in 27.Conclusion:The etiology of external intervertebral foramen’s cervical nerve compression syndrome lies in the compression of cervical plexus,brachial plexus and cervical dorsal rami by the tendious decussating fibers of the scalenus anticus,medius and minimus and the posterior muscles of neck.

关 键 词：颈神经 卡压综合征 颈肩部 上肢 保守治疗 头面部 小斜角肌 主要症状 椎间隙狭窄 乏力 

分 类 号：R681.55[医药卫生—骨科学] R745[医药卫生—外科学]