颈椎病伴颈源性眩晕的临床分析  

Clinical Analysis of Cervical Spondylosis Combined with Cervicogenic Vertigo

作　　者：方凯[1] 冯大雄[1] 赵家凭 

机构地区：[1]泸州医学院附属医院脊柱外科,四川泸州646000

出　　处：《华西医学》2014年第8期1450-1453,共4页West China Medical Journal

摘　　要：目的探讨伴颈源性眩晕的颈椎病发病机制和颈前路手术疗效。方法对2008年3月-2012年11月收治的293例颈椎病患者中83例伴有颈源性眩晕者进行手术治疗,其中神经根型颈椎病23例,脊髓型颈椎病60例。病变涉及单节段29例,2个节段50例,3个节段4例。对全部病变节段均行前路减压固定融合术。观察比较术前、术后3 d、及末次随访时眩晕缓解情况,采用颈性眩晕症状与功能评估量表30分法评定眩晕及主观满意情况,日本骨科学会评估治疗分数法评定神经脊髓功能改善情况。结果随访12～30个月,平均21个月。两种评分在术后3 d、末次随访与术前比较差异有统计学意义（P〈0.05）,末次随访与术后3 d比较差异无统计学意义（P〉0.05）。结论颈源性眩晕手术效果往往伴随脊髓和神经根症状改善而缓解,颈椎病伴颈源性眩晕采取手术治疗是一种有效的方法。Objective To explore the pathogenesis of cervical spondylosis combined with cervicogenic vertigo, and to investigate the clinical results of anterior discectomy and fusion in treating the disease. Methods A retrospective study was performed on 83 patients with cervical spondylosis myelopathy（n=60, 72%） or radiculopathy（n=23, 37.3%） accompanied by sympathetic symptoms such as dizziness between March 2008 and November 2012. The disease involved single segment in 29 cases, double segment in 50 cases, and triple in 4 cases. All the segments involved were treated with anterior discectomy and fusion. Vertigo alleviation was observed before surgery, 3 days after surgery, and during the final follow-up. Neurological status was evaluated by Japanese Orthopedic Association（JOA） score system and sympathetic symptoms were evaluated with vertigo symptom and function scoring system. Results The average follow-up was 21 months（ranging from 12 to 30 months）. Significant difference was observed between sympathetic symptom scores and JOA scores before surgery and 3 days after surgery or at the final follow-up（P〈0.05）, but no significant difference was found between the scores 3 days after surgery and during the final follow-up（P〉0.05）. Conclusions The surgical effect for cervicogenic vertigo is often accompanied by the relief of spinal cord and nerve roots symptoms. Surgery is effective for cervical spondylosis combined with cervicogenic vertigo.

关 键 词：颈源性眩晕 特点 机制 治疗 

分 类 号：R681.55[医药卫生—骨科学]