A MULTICENTRE STUDY
A MULTICENTRE STUDY
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发表时间：
2010
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通讯作者：
S. Imagama;Y. Matsuyama;Y. Yukawa;N. Kawakami;M. Kamiya;T. Kanemura;N. Ishiguro;Ñ. S. Imagama
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作者：
S. Imagama;Y. Matsuyama;Y. Yukawa;N. Kawakami;M. Kamiya;T. Kanemura;N. Ishiguro;Ñ. S. Imagama
我们回顾了1858例接受颈椎椎板成形术的患者，发现43例（2.3%）发生C5麻痹，三角肌MMT（MRC）等级为0 - 2，有或没有二头肌受累，但没有任何其他肌肉的肌力损失。比较有（P组; 43例患者）和无（C组; 100例患者）C5麻痹患者的临床特征和放射学表现。P组C5椎间孔明显变窄（p < 0.005），上级关节突增大（p < 0.05）。MRI上，P组C4-5脊髓后移明显大于C组（p < 0.01）。这项研究是第一个将C5神经根损伤与C5麻痹相关联的研究。对易感个体早期椎间孔切开术和避免过度椎板成形术导致脊髓栓系可能会预防术后C5神经根麻痹。
We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.