颈椎病发病机制的研究

目的 研究颈椎病的发病机制。方法 通过比较脊髓型颈椎病患者的临床表现、影像学资料和颈前路手术切除的颈椎减压标本的组织学表现，分析与颈椎病相关的因素和机制。结果 48例脊髓型颈椎病患者前路减压术后优良率占83％（40例）；18个患者的20例减压完整标本中，以颈椎盘突出为颈椎病主要发病原因者14个占70％，以椎体后缘骨赘压迫为颈椎病主要发病原因的5个占25％。颈椎间盘后缘有炎细胞浸润的占55％，1例退变的非突出的的颈椎间盘也有明显的炎细胞浸润。有炎细胞浸润的患者，其脊髓神经功能损害程度比无炎细胞浸润者重（神经功能评分，P＜0．01）。结论 除了突出的颈椎间盘和椎体后缘形成的骨赘压迫，退变突出的颈椎间盘产生的炎症反应在颈椎病的发病中同样起重要作用。

Study on pathogenesis of cervical spondylosis

Objective To study the pathogenesis of cervical spondylosis Method: The clinical presents and data of images and histologic observation from preparations which were cut by the anterior cervical surgery of the patients with cervical spondylotic myelopathy were compared to analyse the factors and mechanism related to cervical spondylosis Results In 48 cases,40 cases were excellent and good(83%) In 20 preparations from 18 patients,14 were cervical disc herniation (70%)that were as pathogenic factor of cervical spondylotic myelopathy,and 5 were vertebral osteophyte Inflammatory cells were abundantly present in the posterior margin of cervical discs in 11(55%);in 1 preparation, inflammatory cells were observed in degenerated nonherniated cervical disc The degrees of spinal cord and nerve function injury of patients whose cervical discs had inflammatory cells infiltration were more severe than that of patients with deficit of inflammatory cells infiltration (Evaluation in nerve function, P <0 01) Conclusion Except for the mechanical compression from herniated cervical disc and posterior margin vertebral osteophyte,the inflammation in degenerated and herniated cervical disc plays an important role in pathogenesis of the cervical spondylosis