颈椎不稳致交感型颈椎病的诊断和治疗

目的 探讨交感型颈型病的发病机制及有效的治疗方法。方法 回顾了1989-1998年应用颈前路间盘切除加植骨融合术治疗的交感型颈椎病患者18例，分析了患者产及术后颈椎伸、屈侧位X光片。结果 18例患者术前均有颈椎不稳，不稳定节段为1个者6例，2个者9例，3个者3例；颈椎不稳主要发生于C3-C4和C4-C5，偶见于C5-C6和C6-C7。14例患者术前行颈椎高位硬膜外封闭，11例有效；于不稳定节段行颈前路间盘切除加植骨融合术，18例均获随访，平均随访时间为1年9个月，术后有效率为88.9%，结论 颈椎不稳定是交感型颈椎病发病的重要因素。颈椎高位硬膜外封闭具有重要的诊断价值。颈前路间盘切除加植骨融合术是治疗交感型颈椎病的有效方法。

The role of cervical instability in sympathetic cervical spondylosis

Objective To investigate the etiology and treatment ofsympathetic cervical spondylosis. Methods Eighteen patients who underwent anterior cervical discectomy and fusion for sympathetic cervical spondylosis were reviewed retrospectively. Lateral views in flexion and extension of the pre- and postoperative cervical roentgenograms were analyzed to quantify cervical instability. Results Cervical instability was found at one level in 6 patients, two levels in 9 patients, and three levels in 3 patients. Cervical instability mainly took place at C3-C4 and C4-C5, occasionally at C5-C6 or C6-C7. Cervical epidural block was performed in 14 patients and it was effective in 11 patients. Cervical discectomy and fusion at unstable segement was carried out in all 18 patients. The effective rate was 88.9%. Conclusions Cervical instability in the upper cervical spine was an importmant factor in the etiology of sympathetic cervical spondylosis.Cervical epidural block may provide diagnostic information. Anterior cervical discectomy and fusion are effective to treat sympathetic cervical spondylosis.