脊髓型颈椎病与神经根型颈椎病合并颈性眩晕的手术疗效分析

doi:10.13418/j.issn.1001-165x.2020.02.023

摘要/Abstract

摘要： 目的分析不同手术方式对脊髓型或/和神经根型颈椎病合并眩晕患者的治疗效果。方法回顾性分析62例脊髓型或/和神经根型颈椎病合并眩晕的患者，其中34例行颈后路单开门椎板减压成形术（LAM组），28例行颈前路椎间盘切除植骨融合术（ACDF组），采用美国耳鼻咽喉头颈外科学会听力及平衡委员会（CHE）标准，记录患者手术前后评分，分析两种手术方式对颈性眩晕的改善情况，比较不同病变节段颈性眩晕的发生率。结果 LAM组中，32例术后眩晕症状明显改善，其中25例症状完全消失；2例症状无明显缓解，眩晕症状缓解率94.11%。ACDF组中，27例术后眩晕症状明显改善，其中25例症状完全消失；1例症状无明显改善，眩晕症状缓解率96.42%。在ACDF组患者中，间盘退变发生在C3/4，C4/5，C5/6，C6/7不同节段，眩晕的发生率无统计学差异。结论手术治疗对改善脊髓型颈椎病或/和神经根型颈椎病患者合并的眩晕症状是有效的，两种手术方式对颈性眩晕的缓解率无统计学差异。

关键词: 颈椎病, 　颈性眩晕, 　手术治疗

Abstract: Objective　To analyze the therapeutic effect of different surgical intervention on patients who suffered from vertigo induced by cervical spondylotic myelopathy and/or radiculopathy retrospectively. Methods 　62 patients diagnosed with cervical vertigo induced by cervical spondylotic myelopathy and/or radiculopathy were analyzed. Posterior cervical open-door laminoplasty was performed by 34 patients (LAM group), anterior cervical discectomy and fusion was performed by the rest 28 patients (ACDF group). The Committee on Hearing and Equilibrium(CHE) standards were used to record the scores of patients before and after operation, to analyze the improvement of cervical vertigo after two different surgical methods, and compare the incidence of cervical vertigo in different lesions segments．Results　In the LAM group, vertigo symptoms in 32 cases improved significantly after operation, including 25 cases completely disappeared, but the symptoms of other 2 cases had no significant remission．The remission rate of vertigo symptom was 94.11%. In the ACDF group, vertigo symptoms in 27 cases improved significantly after operation, including 25 cases completely disappeared, but the symptoms of other 1 cases had no significant remission．The remission rate of vertigo symptom was 96.42%. There were no statistical difference in incidence of vertigo when degeneration occurred in segments of C3/4，C4/5，C5/6，C6/7 in ACDF group.　Conclusions　Surgical treatment is effective in improving the vertigo induced by cervical spondylotic myelopathy and/or radiculopathy，and there is no statistical difference in the remission rate of cervical vertigo between the two surgical methods.

Key words: Cervical spondylosis, 　 Cervical vertigo, 　 Surgical treatment

中图分类号:

R653
R745.4

李瑞峰, 于宝龙, 张沛, 吴一民, 贺永雄, 李文选. 脊髓型颈椎病与神经根型颈椎病合并颈性眩晕的手术疗效分析[J]. 中国临床解剖学杂志, 2020, 38(2): 217-220.

LI Rui-feng, YU Bao-long, ZHANG Pei, WU Yi-ming, HE Yong-xiong , LI Wen-xuan. Surgical treatment analysis for cervical vertigo induced by cervical spondylotic myelopathy and/or cervical spondylotic radiculopathy [J]. Chinese Journal of Clinical Anatomy, 2020, 38(2): 217-220.

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