[Cervical stenosis-Diagnostics and treatment of symptomatic spinal canal stenosis and neuroforaminal stenosis].

Orthopadie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-07-08 DOI:10.1007/s00132-024-04526-2
Daniel Begrich, Marcus Jäger
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Abstract

Cervical stenosis is a clinical picture that is regularly encountered by both hospital physicians and orthopedic surgeons in the daily clinical practice. While advanced cervical spinal canal stenosis may lead to myelopathic symptoms in cases of sufficient manifestation and spinal cord injury, neuroforaminal stenosis leads to radicular symptoms due to compression of the nerve roots. The clinical examination can provide initial clues as to the suspected cause of the patient's symptoms; however, reliable diagnostics are based only on sectional imaging of the cervical spine. Depending on the extent of the symptoms, the treatment options vary between nonsurgical treatment for moderate symptoms without neurological deficits and surgical decompression of the spinal cord or nerve roots. The surgical treatment can be performed from anterior or posterior depending on the findings. Surgery can lead to an improvement of the neurological symptoms; however, the primary aim of surgical treatment is to avoid deterioration of the neurological deficits.

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[颈椎管狭窄症-症状性椎管狭窄症和神经孔狭窄症的诊断和治疗]。
颈椎管狭窄是医院内科医生和骨科医生在日常临床实践中经常遇到的一种临床表现。晚期颈椎管狭窄在充分表现和脊髓损伤的情况下可能会导致髓病症状,而神经孔狭窄则会因压迫神经根而导致根性症状。临床检查可为患者症状的疑似病因提供初步线索,但可靠的诊断只能基于颈椎的切面成像。根据症状的严重程度,治疗方法有两种,一种是对无神经功能障碍的中度症状进行非手术治疗,另一种是对脊髓或神经根进行手术减压。手术治疗可根据检查结果从前方或后方进行。手术可以改善神经症状,但手术治疗的主要目的是避免神经功能缺损的恶化。
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