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-  2018 

颈椎多节段减压术后C5神经根麻痹的临床分析 Outcomes and Analysis of C5 Nerve Root Palsy After Multilevel Decompression of Cervical Spine

Keywords: 第5颈椎神经根麻痹,颈椎病,颈椎减压,术后恢复

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Abstract:

目的:分析比较颈椎多节段减压术后第5颈椎神经根麻痹(C5NRP)的发生机制、临床表现及预后。方法:回顾性分析了武汉大学人民医院脊柱外科自2011年3月至2014年6月治疗并获得随访的107例颈椎多节段减压术的患者临床资料,分析术式、原发疾病类型对C5NRP发生率的影响。结果:发生术后C5NRP的12例患者在不同术式中的分布情况各异,但与对照组无明显差异。后路手术的C5NRP发生情况包括,颈后路多节段椎板成形术6/47例(12.7%),颈后路多节段椎板切除加融合术4/28(14.3%),明显高于颈前路多节段椎体次全切除加融合术2/32例(6.2%),C5神经根麻痹以单侧为主,前后路手术及发生侧别的差异均有统计学意义(P<0.05)。所有12例C5NRP患者获得随访时长为9-36个月,平均23.6月。术后C5NRP患者症状获得改善的时间为2-32周,平均9.7周。患者术前JOA评分平均7.6±1.9,术后出现不同程度减退(6.1±1.5);患者术前肌力平均3.7级(2-5级),术后C5NRP肌力平均2.9级(1-4级),末次随访平均为4.0级(2-5级)。末次随访的JOA评分改善率、受累三角肌肌力改善明显。结论:颈椎多节段前后路减压术后可发生C5神经根麻痹,后路手术发生C5NRP明显较前路手术高,男性患者风险高于女性患者

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