脊髓型颈椎病影像学表现及手术治疗现状

Imaging Findings and Surgical Treatment Status of Cervical Spondylotic Myelopathy

摘要: 脊髓型颈椎病(Cervical Spondylotic Myelopathy CSM)是骨科常见病、多发病。是一种以退变为主要因素，继发创伤、劳损等多方面诱因，形成以颈椎曲度改变，骨质增生，颈椎间盘突出，后纵韧带、黄韧带骨化钙化，伴有原发、继发椎管狭窄等一系列病理改变，从而压迫脊髓出现众多神经、反射症状的一种退行性疾病。这些相关病理改变大部分可以通过颈椎影像学检查发现，同时，影像学检查也是临床上诊断CSM的方式之一。CSM一旦出现脊髓功能障碍，多数会进行性加重，所以手术治疗已经成为脊柱外科医生的共识。CSM的手术方式非常成熟，采用直接、间接椎管减压等多种手术方式治疗均能取得不同程度的疗效，术式选择问题也是近年来颈椎手术讨论的热点，而具体手术方式多根据患者的病情状况而定。

Abstract: Cervical spondylotic myelopathy is a common and frequently occurring disease in department of orthopedics. It is a variety of factors degenerative disease such as degeneration, secondary trauma and strain, such as cervical curvature change, bone hyperplasia, cervical intervertebral disc her-niation, posterior longitudinal ligament, yellow toughened belt calcification, accompanied by a se-ries of pathological changes such as primary and secondary spinal canal stenosis, which oppress the spinal cord to appear many nerve and reflex symptoms. Most of these pathological changes can be found through cervical imaging examination. Meanwhile, imaging examination is also one of the ways to diagnose CSM in clinic. Once spinal cord dysfunction occurs in CSM, most of them will aggravate progressively, so surgical treatment has become the consensus of spine surgeons. The operation mode of CSM is very mature, and the treatment of direct and indirect decompression of vertebral canal can achieve different curative effect. The choice of operation is also the hot spot in the discussion of cervical surgery in recent years, and the specific operation mode depends on the patient’s condition.