脊髓型颈椎病的治疗进展研究

脊髓型颈椎病(CSM)是颈椎退变引起脊髓长期受压变性,继而导致脊髓功能障碍的疾病,是最严重的一类颈椎病。一旦确诊CSM建议尽早拟定治疗方案,可分为非手术的保守治疗和手术治疗。非手术治疗干预具有一定的疗效,应是早期干预最为经典、传统、首选的方案。若经规范保守治疗无效或进行性神经功能障碍表现加重需尽早行手术治疗避免脊髓损害加重甚至不可逆损伤。手术治疗目的在于解除脊髓压迫、扩大椎管、恢复脊髓功能以及重建颈椎稳定性。目前临床CSM手术治疗入路有前路、后路、前后联合入路3种方式,各有优缺点。治疗方案选择应综合考虑多种因素,采取个性化治疗方案。

Progress in treatment of cervical spondylotic myelopathy

Cervical spondylotic myelopathy (CSM) is the most serious type of cervical spondylosis,which is caused by the degeneration of the cervical spine and the ensuing long-term compressive deformation of the spinal cord,then leading to spinal cord dysfunction.Once CSM is diagnosed,it is recommended to develop treatment plans as soon as possible,which can be divided into nonsurgical conservative treatment and surgical treatment.Non-surgical intervention has a certain curative effect and should be the most classical,traditional and first choice for early intervention.If conservative treatment fails or progressive neurological dysfunction worsens,surgery should be performed as soon as possible to avoid aggravation of spinal cord injury or even irreversible injury.The surgical treatment aims to relieve spinal cord compression,dilate the spinal canal,restore spinal cord function and restore cervical stability.At present,there are three approaches for surgical treatment for CSM in clinical practice:anterior approach,posterior approach and combined anterior and posterior approach,each of which has its own advantages and disadvantages.Various factors should be considered in the selection of treatment plan,and individualized treatment plan should be adopted.