长时间牵引治疗脊髓-神经根型颈椎病△

Long- time traction for cervical radiculomyelopathy

摘要:

[目的] 探讨基于 Ilizarov 理论长时间牵引对脊髓-神经根型颈椎病患者的治疗效果。[方法] 选取 2016 年 1 月— 2021 年 12 月脊髓-神经根型颈椎病患者 56 例，按随机数字表法，28 例行长时间牵引，28 例行常规牵引。 比较两组临床、电生理结果。[结果]两组患者均顺利完成牵引治疗，治疗过程中未出现不良反应。两组治疗 4 周后 VAS、JOA 评分较治疗前均显著改善（P＜0.05），两组治疗前 VAS、JOA 评分差异均无统计学意义（P＞0.05），治疗 4 周后，长时间组 VAS、JOA 评分均显著优于常规组（P＜0.05）。与治疗前相比，两组治疗 4 周后，正中神经及尺神经电位潜伏期显著缩短（P＜0.05），传导速度显著提高 （P＜0.05）。治疗前两组间正中神经及尺神经 F 波潜伏期、传导速度差异均无统计学意义（P＞0.05）。治疗 4 周后长时间组正中神经及尺神经 F 波潜伏期、传导速度均显著优于常规组（P＜0.05）。[结论]延长牵引治疗时间能有效改善脊髓-神经根型颈椎病患者的临床症状及电生理表现，疗效优于常规牵引疗法。

Abstract:

[Objective] To investigate the clinical outcomes of long-time traction based on Ilizarov theory for cervical radiculomyelopa- thy. [Methods] A total of 56 patients with cervical radiculomyelopathy were enrolled in this study from January 2016 to December 202, and were divided into two groups by using random number table method. Of them, 28 patients received long -ime traction, while the other 28 pa- tients underwent conventional traction. The clinical and electrophysiological documents were compared between the two groups. [Results] All patients in both groups had traction treatment performed smoothly withou adverse reactions during the treatment. The VAS scores and JOA scores significantly improved 4 weeks after treatment in both groups compared with those before treatment (P＜0.05). Although there were no significant differences in VAS score and JOA score between the two groups before treatment (P＞0.05), the long-time group proved significantly superior to the conventional group in above scores 4 weeks after treatment (P＜0.05). In addition, median nerve and ulnar nerve potential latency were significantly shortened, while the conduction velocity significantly accelerated in both groups 4 week after treatment compared with those before treatment (P＜0.05), which were not statistically significant between the two groups before treatment (P＞0.05), whereas the long-time group proved significantly superior to the conventional group 4 weeks after treatment (P＜0.05). [Conclusion] Pro- longed traction therapy can effectively improve the clinical symptoms and electrophysiological manifestations of cervical radiculomyelopathy with better clinical efficacy over the conventional traction therapy.