颈椎退行性脊髓病,全景复查

Bryam Esteban Coello García, Daniel Guillermo Calle Rodas, Vicente Xavier Vicuña Carbaca, Lizbeth Mariana Riofrio Loaiza, Diana Lorena Pedrosa Astudillo, Cecibel Carolina Mogrovejo Zúñiga, Ana Magdalena Jiménez Araujo, Holger Xavier Rojas Espinoza, Esteban Sebastian Rodas Luna, Edisson Gustavo González Reinoso
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摘要

导言:颈椎退行性脊髓病(DCM)是一个笼统的术语,包含多种病因。目的:详细介绍目前与颈椎退行性脊髓病、流行病学、临床表现、辅助检查的作用、病理生理学、发病机制和治疗相关的信息。方法:本综述共分析了 32 篇文章,包括综述性文章、原创性文章以及临床病例,由于其他文章与本研究无关,因此使用了其中的 21 篇文献目录。信息来源于PubMed、Google Scholar和Cochrane;搜索西班牙文、葡萄牙文和英文信息时使用的术语为:颈椎退行性脊髓病、颈椎病、颈椎疼痛、黄色韧带骨化和椎间盘退行性病变。脊髓损伤(SCI)是一种破坏性疾病,对神经系统的发病率和生活质量造成严重影响。结论:颈椎退行性脊髓病涉及多种病因,所有这些实体共同构成了成人脊髓退行性和非创伤性改变的最常见原因。退行性病变更常见于 C5 和 C6 或 C6 和 C7,因为这些部位的活动度增加。由于疾病过程的病因是多因素的,因此很难获得可靠的流行病学数据。病理表现出的症状和体征多种多样,因此应进行充分的体格检查并详细询问临床病史。这种病变可严重改变神经功能并导致残疾,因此早期识别和治疗可防止患者病情进一步恶化。手术减压几乎是普遍适用的治疗方法,目的是防止病情恶化并实现最大的康复潜力。关键字:脊髓病、颈椎病、退行性病变、疼痛、脊柱、神经痛。
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CERVICAL DEGENERATIVE MYELOPATHY, PANORAMIC REVIEW
Introduction: cervical degenerative myelopathy (DCM) is a general term that entails multiple etiologies. DCM is a group of pathological entities that originate compression of the cervical spinal cord, where spasticity, hyperreflexia, pathological reflexes, loss of manual dexterity, among others, are found. Objective: to detail the current information related to cervical degenerative myelopathy, epidemiology, clinical presentation, role of complementary examinations, pathophysiology, pathogenesis and treatment. Methodology: a total of 32 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 21 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: cervical degenerative myelopathy, cervical spondylotic myelopathy, cervical pain, ossification of the yellow ligament and degenerative disc disease. Results: cervical myelopathy occurs in almost all individuals with canal stenosis greater than 60%. Spinal cord injury (SCI) is a devastating disorder that influences remarkable neurological morbidity and significant wear and tear on quality of life. The incidence and prevalence of SCI in North America is between 4.1 and 60.5 per 100,000, robust epidemiological data is difficult to obtain because of the multifactorial etiology of the disease process. Conclusions: cervical degenerative myelopathy involves multiple etiologies, all these entities together represent the most common reason for degenerative and non-traumatic alteration of the spinal cord in adult individuals. Degenerative disorders are more common at C5 and C6 or C6 and C7, because of the increased mobility in these sections. It is difficult to obtain solid epidemiological data because of the multifactorial etiology of the disease process. The symptoms and signs presented by the pathology are varied, so an adequate physical examination and a good clinical history should be taken. The pathology can significantly alter neurological function and lead to disability, so early recognition and treatment can prevent further deterioration of affected individuals. Surgical decompression is almost universally indicated with the intention of preventing progression and achieving maximum recovery potential. KEY WORDS: myelopathy, cervical, degenerative, pain, spinal, neuralgia.
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