[Clinical study of cervical radiculopathy after laminoplasty for cervical myelopathy].

Nihon Seikeigeka Gakkai zasshi Pub Date : 1995-12-01
K Sasai, T Saito, S Akagi, H Watanabe
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Abstract

We have retrospectively determined the preoperative risk factors in cervical radiculopathy after laminoplasty for cervical myelopathy using preoperative neuroradiographical findings and electrophysiological studies. Of the 67 patients who underwent laminoplasty, 10 patients (14.9%) postoperatively showed cervical radioculopathy. The preoperative radiographical findings had included cervical lordosis, intraspinal cord centering, and anterior protrusion of the apex of the superior articular process. Needle electromyography, somatosensory evoked potentials (SEPs), sensory nerve action potentials (SNAP) were preoperatively examined in 42 cases. There was no relationship between the postoperative radiculopathy and the preoperative radiographical findings. Six (100%) of 6 cases preoperatively diagnosed as C5 radiculopathy (postganglionic type) with Erb-P 14 interpeak latency of dermatomal SEPs and SNAP, developed postoperative C5 radiculopathy. One (25%) of 4 cases preoperatively diagnosed as C6 radiculopathy developed postoperative C6 radiculopathy. No case preoperatively diagnosed as C7 or C8 radiculopathy developed postoperative radiculopathy. This study suggested that an important risk factor for postoperative radiculopathy was subclinical C5 radiculopathy (postganglionic type) that could be preoperatively evaluated using electrophysiological studies.

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颈椎病椎板成形术后颈神经根病的临床研究。
我们回顾性地确定了颈椎病椎板成形术后颈椎病的术前危险因素,利用术前神经影像学检查和电生理研究。67例行椎板成形术的患者中,10例(14.9%)术后出现颈椎放射性眼病。术前x线检查结果包括颈椎前凸,脊髓内居中,上关节突尖前突。术前检查42例患者的针肌电图、体感诱发电位(sep)、感觉神经动作电位(SNAP)。术后神经根病与术前影像学检查无关系。6例术前诊断为C5神经根病(节后型),伴有皮皮sep和SNAP的erb - p14峰间潜伏期,术后发生C5神经根病6例(100%)。术前诊断为C6神经根病的4例患者中有1例(25%)术后发展为C6神经根病。术前诊断为C7或C8神经根病的病例无术后发生神经根病。本研究提示,术后神经根病的一个重要危险因素是亚临床C5神经根病(神经节后型),可通过术前电生理研究进行评估。
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