[颈椎间盘突出症:症状学、诊断学、治疗学]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-11-19 DOI:10.1007/s00132-024-04582-8
Dorothea Daentzer, Bastian Welke, Ahmed Baseem Ismail, Jannik Daentzer, Jochen Plagge
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引用次数: 0

摘要

背景:虽然颈椎间盘突出症总体上比较罕见,但骨科和神经外科医生经常会遇到这种临床表现的患者。起初,患者通常会有严重的局部疼痛,主要是根性疼痛,上肢也会出现与皮肤相关的神经功能障碍,偶尔也会发现髓核征象:完全缓解的预后通常良好,因此主要治疗几乎都是保守疗法。根据指南,可以根据疼痛症状和神经功能缺损情况得出手术的相对和绝对指征:手术治疗:有多种手术方法可供选择。最常选择的是颈椎腹侧入路术,植入椎体笼,以达到融合的目的,或植入椎间盘假体作为关节成形术。对于外侧椎间盘脱出,建议采用背侧椎板切除术和椎间孔切除术。术后效果主要良好,并发症发生率相对较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cervical disc herniation : Symptomatology, diagnostics, therapy].

Background: Although herniated discs in the cervical spine are rare overall, patients with this clinical picture regularly present themselves in orthopedic and neurosurgical practice. Initially, those affected often have severe local and predominantly radicular pain and, optionally, dermatome-related neurological deficits in the upper extremities, with medullary signs occasionally being found.

Prognosis: The prognosis for complete remission is usually favorable, so that primary therapy is almost always conservative. Based on guidelines, the relative and absolute indications for surgery can be derived depending on pain symptoms and neurological deficits.

Surgical treatment: There are various surgical procedures to choose from. The ventral approach to the cervical spine with either insertion of a cage and the goal of fusion or implantation of an intervertebral disc prosthesis as arthroplasty is most often chosen. For lateral disc prolapse, dorsal foraminotomy with sequestrectomy is recommended. The postoperative outcome is predominantly positive with a relatively low complication rate.

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