寰枢椎脱位外科治疗与疏通督脉瘀阻相关性研究

目的:探讨寰枢椎脱位外科治疗与疏通督脉的相关性。方法:2004年6月至2010年6月,对113例(男65例,女48例;年龄8～64岁,平均42.6岁)寰枢椎脱位患者按TOI分型分为T1、T2、O、I4组,并给予外科治疗,主要包括牵引、手术复位融合固定。分别对比各组治疗前后寰椎平面SAC(脊髓有效空间)、督脉经络瘀阻症候积分、JOA评分、NDI评分(颈椎功能障碍指数)。结果:T1、T2、O、I组患者寰椎平面SAC术前分别为(13.34±3.21)、(10.43±2.42)、(7.89±3.14)、(10.50±0.71)mm,末次随访分别为(16.02±1.42)、(15.34±1.87)、(14.49±1.58)、(12.50±0.71)mm;督脉经络瘀阻证候积分术前分别为(8.37±1.87)、(6.87±1.35)、(5.17±1.13)、(7.50±0.71),末次随访分别为(10.59±0.94)、(10.25±1.01)、(8.41±1.31)、(9.0±0);JOA、NDI评分较术前明显改善。结论:采用TOI外科分型治疗寰枢椎脱位,在明显改善神经功能的同时,也有效地缓解督脉经络瘀阻的症状,表明外科治疗与疏通督脉有密切相关性。

Research on the correlation between surgical treatment for atlantoaxial dislocation and dredging Governor vessel

Objective:To research the correlation between surgical treatment for atlantoaxial dislocation and dredging Governor vessel. Methods:From June 2004 to June 2010,113 patients were reviewed,including 65 males and 48 females,with the mean age of 42.6 years(ranged,8 to 64 years). All the patients were classified and treated by TOI clinical classification which included traction and decompression and reduction,and inter fixation fusion by surgery. The SAC(space available for the cord),Governor vessel Yuzu score,JOA score,NDI score (cervical spine dysfunction index) before treatment were compared with those of after treatment. Results:The SAC in each group before treatment were (13.34±3.21),(10.43±2.42),(7.89±3.14),(10.50±0.71) mm respectively,the last follow-up of (16.02±1.42),(15.34±1.87),(14.49±1.58),(12.50±0.71) mm;Governor vessel Yuzu score before treatment were (8.37±1.87),(6.87±1.35),(5.17±1.13),(7.50±0.71) respectively,the last follow-up of(10.59±0.94),(10.25±1.01),(8.41±1.31),(9.0±0);JOA,NDI score significantly improved compared with that of before treatment. Conclusion:Atlantoaxial dislocation confirmed and treated by TOI clinical classification can effectively relieve the nerve function and Governor vessel Yuzu syndrome,and show that surgical treatment is closely related with dredging the Governor vessel.