天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (11): 1198-1201.doi: 10.11958/20170807

• 临床研究 • 上一篇    下一篇

颈椎后路减压并发 C5神经根麻痹的病因分析

荆峰，邓树才，马毅   

  1. 天津市天津医院脊柱外科
  • 收稿日期:2017-07-13 修回日期:2017-08-17 出版日期:2017-11-15 发布日期:2017-11-15
  • 通讯作者: 荆峰 E-mail:angelsland@sina.com

Analysis of C5 palsy with C4/5 foraminotomy after posterior cervical decompression surgery

JING Feng,DENG Shu-cai,MA Yi   

  1. Department of Spine, Tianjin Hospital
  • Received:2017-07-13 Revised:2017-08-17 Published:2017-11-15 Online:2017-11-15

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摘要： 目的 探讨颈椎后路全板减压术中行 C4~5神经根孔扩大减压预防术后 C5神经根麻痹的有效性及其病因分析。方法 回顾性分析 2011 年 1 月—2015 年 12 月收治的 127 例行颈后路全板减压侧块内固定术的患者资料，男 62 例，女 65 例。其中，A 组 61 例（男 28 例，女 33 例）行后路 C3～7全椎板减压固定，B 组 66 例（男 34 例，女 32 例）后路 C3～7减压固定的同时行 C4～5双侧椎间孔扩大减压术。回顾性分析 2 组患者术后 C5神经根麻痹的发生率和脊髓功能改善率差异。结果 2 组组内手术前、后 JOA 评分及颈椎曲度指数（CCI）变化的比较，差异有统计学意义。术后出现 C5神经根麻痹症状 A 组 11 例（18.03%），B 组 3 例（4.55%），2 组发生率差异有统计学意义（P=0.022）。结论 颈椎后路全板减压能有效改善脊髓功能，C5神经根通道扩大减压能有效预防术后发生 C5神经根麻痹。

关键词: 麻痹, 神经根病, 颈椎, 减压术, 外科, C5神经根麻痹, C4～5椎间孔减压术, 颈椎后路减压术

Abstract: Objective To evaluate the effects of C4-5 partial foraminotomy on reducing the occurrence of C5 palsy after posterior cervical decompression surgery. Methods A total of 127 patients (male 62, female 65) underwent the cervical decompression surgery with lateral cervical mass screw insertion between January 2011 and December 2015 were retrospectively analyzed. In these patients sixty-one cases (Group A) underwent the posterior laminectomy with lateral cervical mass screw insertion, while 66 cases (Group B) received posterior laminectomy with lateral cervical mass screw insertion, combined with partial C4/5 foraminotomy at C4-5 level. The clinical data, radiographic parameters and the occurrence of C5 palsy were assessed in two groups of patients. Results There was no significant difference in JOA recovery rate and change of cervical curvature index between preoperation and postoperation in each group (P＞0.05). Postoperative C5 palsy occurred in 11 cases (18.03%) in group A and 3 cases (4.05%) in group B. The difference in the incidence of C5 palsy was significant between the two groups (P=0.022). Conclusion The cervical decompression surgery can improve the function of the spinal cord effectively. C4-5 partial foraminotomy after cervical decompression surgery is effective for preventing C5 palsy.

Key words: paralysis, radiculopathy, cervical vertebrae, decompression, surgical, C5 palsy, C4-5 foraminotomy, posterior cervical decompression surgery

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