轻型脊髓型颈椎病保守治疗效果与髓核突出类型的相关性研究

    Relationship between type of soft disc herniation causing mild cervical spondylotic myelopathy and effect of conservative treatment

    • 摘要: 目的: 探讨不同类型颈椎间盘突出引起的轻型脊髓型颈椎病与保守治疗效果的相关性。方法: 选取经保守治疗的由颈椎间盘突出引起的轻型脊髓型颈椎病患者28例(JOA评分>12分)。根据疗效分组,症状较前减轻或原先症状较轻,治疗后症状无恶化为A组(16例);症状加重或原先症状较重,治疗后无改善者为B组(12例)。通过分析治疗前MRI图像,比较两组间椎间盘突出类型的差异。结果: 治疗前A组JOA评分与B组差异无统计学意义(P>0.05);治疗后A组JOA评分与B组差异有统计学意义(P<0.001)。在矢状面上,A组颈椎间盘突出局限型占37%,弥散型占63%;B组局限型占75%,弥散型占25%(P=0.067)。在横断面上,A组中央型占75%,旁中央型占25%;B组中央型占25%,旁中央型占75%(P=0.020)。结论: 弥散型和中央型颈椎间盘突出引起的轻型脊髓型颈椎病保守治疗效果较好,而局限型和旁中央型保守治疗效果不佳。

       

      Abstract: Objective: To explore relationships between the type of soft disc herniation causing mild cervical myelopathy and effectof conservative treatment. Methods: Twenty-eight patients with mild cervical myelopathy caused by soft disc herniation were selected with JOA scores>12 and divided into two groups according to the therapeutic efficacy. In 16 patients (Group A), their myelopathy improved or their condition remained stable while in the other 12 patients (Group B), they deteriorated neurologically or their disability remained unchanged. The difference of the types of soft disc herniation was compared by MRI. Results: Before treatment, JOA score in group A was 13.94±1.44, in group B 14.1±1.1, without the statistic significance between two groups (P>0.05). After treatment, JOA score in group A was 16.0±0.73, in group B 12.5±0.80 (P<0.001). Diffuse-type herniation was present in 63% of the patients in Group A and 25% in Group B (P=0.067), while median-type herniation was diagnosed in 75% in Group A and 25% in Group B (P=0.020). Conclusions: Patients with a median type and diffuse type CDH on MRI may be more suitable for the conservative treatment.

       

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