【摘要】：[目的]分析伴隨頸椎病的頸性眩暈手術(shù)治療效果及其影響因素。[方法]對(duì)我科2004年01月～2013年12月因頸椎病行手術(shù)治療的共621例患者進(jìn)行篩選,對(duì)其中以眩暈為主要癥狀,同時(shí)伴隨神經(jīng)根型和/或脊髓型頸椎病,排除洱源性眩暈及神經(jīng)血管性眩暈,予保守治療效果不佳并行手術(shù)治療的共35例患者進(jìn)行回顧性分析。其中男13例,女22例,平均年齡55.5歲,平均隨訪40.6個(gè)月,采用美國(guó)耳鼻咽喉頭頸外科學(xué)會(huì)聽力及平衡委員會(huì)(CHE)標(biāo)準(zhǔn),記錄患者術(shù)前及術(shù)后眩暈評(píng)分,以Ishihara法測(cè)定術(shù)前頸椎側(cè)位X片的頸椎曲度指數(shù)(cervical curvature index, CCI),在術(shù)前的頸椎側(cè)位、動(dòng)力位X片上測(cè)量相鄰椎體后緣滑移距離及椎間角,在頸椎側(cè)位及動(dòng)力位X片上以Cobb法測(cè)量頸椎曲度及術(shù)前頸椎活動(dòng)度(cervical range of motion, CROM)。分析手術(shù)療效及影響因素,并探討頸性眩暈的可能機(jī)制。[結(jié)果]臨床功能評(píng)價(jià)：術(shù)前眩暈評(píng)分平均4.3分,術(shù)后平均1.6分,平均改善2.7分,術(shù)后療效滿意為29例患者,滿意率為82.9%。影像學(xué)結(jié)果：35例患者中有33例患者有頸椎不穩(wěn)。統(tǒng)計(jì)學(xué)分析：術(shù)前術(shù)后頸椎側(cè)位X片曲度改善程度與眩暈緩解程度正相關(guān)(r=0.434,P0.05)。術(shù)后眩暈緩解程度與術(shù)前頸椎側(cè)位X片頸椎曲度、CCI值、CROM值、頸椎不穩(wěn)節(jié)段位置、頸椎不穩(wěn)節(jié)段個(gè)數(shù)及術(shù)后頸椎側(cè)位X片頸椎曲度無(wú)明顯相關(guān)性。[結(jié)論]手術(shù)可緩解伴隨頸椎病的頸性眩暈癥狀,頸椎不穩(wěn)可能與頸性眩暈相關(guān),術(shù)前術(shù)后頸椎側(cè)位X片頸椎曲度改善程度與眩暈緩解程度正相關(guān)。
[Abstract]:Objective: to analyze the effect of surgical treatment of cervical vertigo associated with cervical spondylosis and its influencing factors. [methods] A total of 621 patients with cervical spondylosis were selected from January 2004 to December 2013. Vertigo was the main symptom and accompanied by cervical spondylopathy of nerve root type and / or myelopathy. 35 patients with eryuan vertigo and neurovascular vertigo who were treated with conservative treatment and surgical treatment were analyzed retrospectively. Among them, 13 males and 22 females with an average age of 55.5 years were followed up for an average of 40.6 months. The score of vertigo before and after operation was recorded according to the (CHE) standard of hearing and balance Committee of the American Academy of Otolaryngology and head and neck surgery. The cervical curvature index (cervical curvature index, CCI),) was measured by Ishihara method. The posterior margin slip distance and intervertebral angle of adjacent vertebrae were measured on dynamic X ray. Cobb method was used to measure cervical curvature and preoperative cervical motion (cervical range of motion, CROM). On lateral and dynamic radiographs of cervical spine. Objective: to analyze the effect of operation and its influencing factors, and to explore the possible mechanism of cervical vertigo. [results] Clinical function evaluation: preoperative vertigo score averaged 4.3 points, postoperative average score 1.6 points, average improvement score 2.7 points, postoperative satisfactory effect in 29 patients, satisfaction rate was 82.9%. Imaging results: 33 out of 35 patients had cervical instability. Statistical analysis: there was a positive correlation between the improvement of cervical lateral X-ray curvature and the degree of relief of vertigo before and after operation (P 0.05). There was no significant correlation between the degree of relief of postoperative vertigo and preoperative cervical curvature, CCI value, CROM value, the position of unstable cervical spine segment, the number of unstable cervical vertebra segment and the cervical spine curvature of lateral position X ray after operation. [conclusion] Cervical vertigo symptoms associated with cervical spondylosis can be alleviated by operation. Cervical instability may be related to cervical vertigo, and the improvement of cervical spine curvature in lateral position before and after operation is positively correlated with the degree of relief of vertigo.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687

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本文編號(hào)：2263142