摘要
目的探讨颈、腰椎疾病同时存在的临床特点和手术策略。方法总结53例颈腰椎疾病同时存在的病例其临床特点和随访结果。单纯颈椎手术19例,单纯腰椎手术16例,颈腰椎同时联合手术7例。所有患者均以JOA评分记述。结果颈、腰椎病变多为颈椎管狭窄、腰椎管狭窄。术后6个月随访结果,77·8%(35/44)症状改善率为优良,其中68·6%(24/35)为单次手术,改善率为75·9%,优良率为80·0%;31·4%(11/35)患者为颈腰椎间断依次手术,改善率为78·4%,优良率为78·5%。13·6%(6/44)单纯颈、腰椎手术患者改善率为中,6·8%(3/44)经2次手术后改善率为中。5例第1次手术时漏诊,29例术前判断存在主病灶,存在主病灶29例中随访25例,改善率为76·5%,优良率为96·0%。结论颈、腰椎病变多为颈椎管狭窄、腰椎管狭窄,椎管狭窄和椎间盘突出的共同基础是脊椎的退变。明确主病灶,确定正确的手术方案,可以获得较好的治疗效果。
Objective To investigate the clinical character and surgical management in coexistence of cervical and lumbar spine disease. Methods 53 cases with coexistence of cervical and lumbar spine disease were analyzed for clinical character and follow-up outcomes. 19 single cervical operation cases, 16 single lumbar operation cases and 7 combined cervical lumbar operation cases, all patients were recorded with JOA score. Results The cases with cervical and lumbar intervertebral disc showed at least 2 segments. After 6 months follow-up, 35/44 cases symptom were relieved obviously, of which 24/35 cases were single operation, relief rote is 75.9%, satisfactory rate is 80. 0% ; of which 11/35 cases were continuous cervical lumbar operation, relief rote is 78. 4%, satisfactory rate is 78.5%. 6/44 cases＇ symptom with only cervical or only lumbar operation were relieved incompletely, 3/44 cases＇ symptom with second operation relieved incompletely. 5 cases missed diagnosis on the first operation. 29 cases with responsible focus, of which 25 cases were followed up, relieved obviously, relief rate is 76. 5%, satisfactory rate is 96. 0%. Condusiola The cases with cervical and lumbar intervertebral disc showed at least 2 segments, the same basis of the spinal canal stenosis and disc herniation is degeneration of spine, certain responsible focus and correct surgical management can get good treatment results.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第11期763-765,共3页
National Medical Journal of China
关键词
颈椎
腰椎
椎管狭窄
椎间盘移位
Cervical vertebrae
Lumbar vertebrae
Spinal stenosis
Intervertebral disc displacement
