CAJ | 학술논문

目的：探讨伴颈神经根病的无症状颈椎退变性脊髓压迫（ asymptomatic spondylotic cervical cord compression， A-SCCC）的治疗。方法回顾分析本院2009年6月～2012年6月收治的34例伴颈神经根病的A-SCCC患者病例资料，患者入院后先接受系统的非手术治疗，如果神经功能无缓解或加重，则行手术治疗，收集患者一般情况及影像学资料，于治疗前后不同时间点通过日本骨科学会（ Japanese Orthopaedic Association， JOA）评分评价临床治疗效果。结果34例患者平均随访4个月，其中23例经非手术治疗获得不同程度的改善；11例改善不明显，其中8例改手术治疗，3例患者继续非手术治疗（2例症状逐渐缓解，1例出现脊髓病临床表现）。治疗后及随访期间非手术组与手术组患者JOA评分均较治疗前明显改善，差异有统计学意义（P＜0．01）。结论多数伴颈神经根病的A－SCCC患者经过系统非手术治疗后病情可以缓解，部分仍需手术治疗，伴颈神经根病或脊髓高信号的A－SCCC不必预防性手术，但需密切观察病情变化。
목적：탐토반경신경근병적무증상경추퇴변성척수압박（ asymptomatic spondylotic cervical cord compression， A-SCCC）적치료。방법회고분석본원2009년6월～2012년6월수치적34례반경신경근병적A-SCCC환자병례자료，환자입원후선접수계통적비수술치료，여과신경공능무완해혹가중，칙행수술치료，수집환자일반정황급영상학자료，우치료전후불동시간점통과일본골과학회（ Japanese Orthopaedic Association， JOA）평분평개림상치료효과。결과34례환자평균수방4개월，기중23례경비수술치료획득불동정도적개선；11례개선불명현，기중8례개수술치료，3례환자계속비수술치료（2례증상축점완해，1례출현척수병림상표현）。치료후급수방기간비수술조여수술조환자JOA평분균교치료전명현개선，차이유통계학의의（P＜0．01）。결론다수반경신경근병적A－SCCC환자경과계통비수술치료후병정가이완해，부분잉수수술치료，반경신경근병혹척수고신호적A－SCCC불필예방성수술，단수밀절관찰병정변화。
Objective To investigate therapeutic methods of asymptomatic spondylotic cervical cord compression ( A-SCCC) combined with symptomatic cervical radiculopathy.Methods From June 2009 to June 2012,34 patients with A-SCCC combined with symptomatic cervical radiculopathy were included in this retrospective analysis. All the cases underwent anterior-posterior, lateral, excessive flexion and extension cervical spine X-ray and MRI.Age, gender, duration of disease and the Pavlov ratio were also collected.Conservative treatment to all patients accepted after admission system, the patients were underwent surgical operation without neural function recovery after normal conservative treatment.Before treat-ment and at different time points after treatment, the Japanese Orthopaedic Association (JOA) scores were calculated to evalu-ate the clinical effect of treatment.Results All of 34 patients were followed up for an average of 4 months, of which 23 patients got different degrees of neural function improvements after conservative treatment, and 11 patients had no obvious improvement.Eight cases without obvious improvement underwent operation, and other 3 patients refused operation treatment of who 2 cases were relieved after continued conservative treatment, and the remaining 1 case developed with clinical manifes-tations of spinal cord disease.The JOA scores in both groups were significantly improved after treatment (P<0.01).Conclu-sion Majority of patients with A-SCCC combined with symptomatic cervical can alleviate the condition after conservative treatment, some still need operation.A-SCCC combined with symptomatic cervical radiculopathy or spinal cord high intensity signal spinal cord do not need preventive operation, but still have to observe the change of the disease closely.