脊髓型颈椎病术后神经功能恢复时间模式研究  

Study of time pattern of nerve functional recovery after cervical stenotic myelopathy surgery

作　　者：龚宗明[1] 张雷[1] 孙晓亮[1] H.Pascal-Moussellard 

机构地区：[1]江苏省常州市第一人民医院 [2]Service d'Orthopédie,CHU Pitié-Salpêtrière,47,boulevard de l'Hoital,75651 Paris Cedex 13

出　　处：《现代中西医结合杂志》2010年第34期4394-4396,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨脊髓型颈椎病术后神经功能恢复时间的模式。方法对42例继发于椎管狭窄的进行性脊髓型颈椎病患者施行外科手术治疗,前方手术入路24例,后方入路18例。于术后1,3,6,12,18个月各随访1次,之后每年随访1次,进行JOA评分。结果术前JOA评分为1~15分,平均8.3分。10例严重患者JOA评分〈6分,术后6个月在随访中保持平稳的JOA平均值为13.3分（3~17分）。最后一次随访应用Hirabayash i技术评估平均为52.5%。神经功能恢复表现在术后第1—3个月,而后维持稳定。JOA评分〉6分和JOA评分〈6分病例神经功能恢复非常相似。在前路与后路手术方式中,患者的神经功能康复无显著性差异。结论该型患者神经功能恢复在术后6个月表现非常迅速,之后则表现平稳,与初始病变严重程度无关。更多比JOA评分系统有效的评分系统应该发展起来应用于此类患者的随访过程中。Objective It is to explore the time pattern of nerve functional recovery after cervical stenotic myelopathy surgery.Methods 42 patients with progressive cervical stenotic myelopathy which induced by spinal stenosis were treated with surgery therapy,including 24 cases with anterior operative route and 18 cases with back operative routs.In 1,3,6,12,18 months＇ later,the patients were followed up once respectively,then they were followed up every year.JOA scores were evaluated at the same time.Results JOA scores were 1-15 before operation,the average scores were 8.3.JOA scores of 10 severe cases6.The average JOA scores were 13.3（3-17） in the following up time of 6 months after operation.In the last following up time,the average was 52.5% evaluated by Hirabayashi technique.The recovery of nerve function began in 1-3 months after operation and keep stable in the future.The recovery of ones whose JOA score6 was very similar to that of ones whose score6.There was also no significant difference in nerve function recovery between anterior operative route and back operative route.Conclusion Nerve functional recovery of this type patients is fast within 6 months after operation,then it keep stable speed,which has nothing to do with the original disease change degree.More evaluating system which are more effective than JOA score system should be developed to apply for the following up of this kind of patients.

关 键 词：脊髓型颈椎病 颈髓减压 椎关节强硬 

分 类 号：R743.3[医药卫生—神经病学与精神病学]