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岭南现代临床外科 ›› 2016, Vol. 16 ›› Issue (01): 67-71.DOI: 10.3969/j.issn.1009-976X.2016.01.017

• 论著与临床研究 • 上一篇    下一篇

青壮年颈椎病患者的临床特点与手术疗效分析

黄岭志 谌业光 黄凯 谢伟文 曾展泉   

  1. 梅州市人民医院
  • 通讯作者: 黄岭志

The clinical feature and surgical treatment of cervical spondylosis in young adults

HUANG Lingzhi, CHEN Yeguang, HUANG Kai, XIE Weiwen, ZENG Zhanquan   

  • Received:2015-12-07 Revised:2016-01-05 Online:2016-02-20 Published:2016-02-20

摘要: 【摘要】 目的 探讨青壮年颈椎病的临床特点、分析其手术疗效。方法〓2009年1月至2015年1月,选择我院诊断为颈椎病并已行手术治疗的青壮年患者(≤40岁)26例,其中男14例,女12例,年龄28~40岁,平均36.7岁。公司职员10例,工厂工人7例,外科医生1例,自由职业8例。脊髓型21例,神经根型3例,脊髓型混合交感型2例。发病至手术时间为3~36个月,平均10个月。分析其可能的发病原因、临床症状、治疗过程,通过JOA或VAS评分来评估手术疗效。结果〓采用前路手术19例,后路手术2例,前后路联合手术5例。所有患者症状均明显缓解。21例脊髓型颈椎病患者中,术后随访3~47个月,平均19个月,JOA评分15~17分,改善率65%~100%。3例神经根型患者,术后随访时间分别为6个月、13个月和15个月,VAS评分均下降至0分。2例脊髓型混合交感型患者术后随访时间为7个月和25个月,JOA评分为17分。随访未发现有内固定松动、断裂、植骨不融合等情况,亦无内固定物造成的神经、脊髓损伤症状以及食管、气管损伤等并发症。结论〓针对青壮年颈椎病具体致病因素采取合适的手术方式可取得满意的手术疗效,但长期效果仍需继续密切随访。

关键词: 临床特点, 颈椎病, 青壮年, 手术疗效

Abstract: 【Abstract】〓Objective〓To investigate the clinical feature of cervical spondylosis in young adults and analyze the effect of surgical treatment. Methods〓From Jan 2009 to Jan 2015, there were 26 young patients were confirmed as cervical spondylosis and underwent surgical treatment, including 14 male and 12 female cases of 28 to 40 years old (average 36.7 years), and 10 staff and 7 workers, 1 surgeon, and 8 cases without regular employment. Of 26 cases, 21 cases of cervical myelopathy, 3 cases of nerve root cervical spondylosis, 2 cases of myelopathy mixed sympathetic. The time from onset to the operation time was 3 to 36 months, averaging 10 months. The possible causes of clinical symptoms, course of treatment were analyzed and evaluated through JOA and VAS score. Results〓The operation was performed in 19 cases through anterior surgery, 2 cases through posterior surgery and 5 cases through the combined surgery. All symptoms were significantly alleviated. A total of 21 cases of cervical spondylotic myelopathy were followed up for 3 to 47 months, averaging 19 months, and JOA score ranged from of 15 to 17, improving rate was from 65% to 100%. Three cases of nerve root cervical spondylosis were followed up 6 months, 13 months and 15 months, respectively, and VAS score decreased to 0. Two cases of myelopathy mixed sympathetic patients were followed up for 7 months and 25 months, the JOA score was 17 points. No fixation loosening, fracture, bone graft fusion failure and spinal cord damage caused by internal fixation were found during follow-up. Conclusion〓Surgical treatment can achieve a satisfactory effect on young adults cervical spondylosis, but long-term effects still need to continue to closely follow-up.

Key words: Young adults, Clinical features, Surgical treatment, Cervical spondylosis

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