伴颈性眩晕颈椎病手术治疗

发布时间：2018-08-31 14:04

【摘要】：[目的]总结伴颈性眩晕颈椎病患者手术疗效,探索该类患者手术治疗指征及手术要点。[方法]收集本院2010年1月~2014年12月伴颈性眩晕颈椎病患者127例,并根据性别、年龄、手术入路、手术节段、术前眩晕评分及术后颈椎前凸角进行分组,统计并比较各组患者改善率及改善度差异。[结果]女性、前路手术及术前评分超过3分患者改善率及改善度明显提高。长节段(2个)、术后颈椎前凸角超过10°患者改善率显著提高,但改善度差异无统计学意义。年龄超过60岁患者改善度显著低于年龄低于60岁患者。[结论]保守治疗无效、女性患者、年龄不超过60岁及眩晕评分超过3分可作为重要的手术指征。尽量选择前路手术,长节段固定不稳定的椎体,重建颈椎曲度有助于提高患者的改善率及改善程度。
[Abstract]:Objective: to summarize the operative effect of cervical spondylosis with cervical vertigo, and to explore the indications and main points of surgical treatment. [methods] 127 patients with cervical spondylosis associated with cervical vertigo from January 2010 to December 2014 were divided into groups according to sex, age, operative approach, operative segment, preoperative vertigo score and postoperative cervical kyphoid angle. The improvement rate and improvement degree of each group were analyzed and compared. [results] the improvement rate and degree of improvement were significantly increased in women, patients with anterior surgery and preoperative score more than 3 points. The improvement rate of patients with long segment (2) and more than 10 掳of cervical kyphosis angle after operation was significantly improved, but there was no significant difference in improvement degree. The degree of improvement in patients over 60 was significantly lower than that in patients younger than 60. [conclusion] conservative treatment is ineffective, female patients, age less than 60 years old and vertigo score more than 3 points can be used as an important indication of surgery. As far as possible, anterior surgery, long segment fixation of unstable vertebrae and reconstruction of cervical curvature are helpful to improve the improvement rate and degree of improvement.
【作者单位】：第二军医大学附属长征医院脊柱三科;
【基金】：国家自然科学基金项目(编号:81572194);国家自然科学基金项目(编号:81371383) 上海市曙光计划项目(编号:13SG38)
【分类号】：R687.3

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