頸椎有問題的病患,愈來愈常見。提早從生活上預防才是重要。
Cervical myelopathy refers to compression on the cervical spinal cord from either a disc herniation or cervical spinal stenosis.
Generally, it is more common in the elderly population and is a slow process. Symptoms include incoordination in the hands, a heavy feeling in the legs, or numbness and tingling in the legs. It is generally a slowly progressive condition. It is usually not painful as compression of the spinal cord does not cause pain.
- clumsiness in hands
- gait imbalance
- caused by compression of the spinal cord
寫得很好的英文資料: Cervical Myelopathy - Spine - Orthobullets.com http://goo.gl/2cVj9h
簡單中文摘要:
Cervical Spondylotic Myelopathy 的症狀和體徵 | Medisato 繁体中文 http://goo.gl/USCVyz
下肢痙攣性無力(spastic weakness of lower limbs)
治療方面:
- Nonoperative
- observation, NSAIDs, therapy, and lifestyle modifications
- indications
- may be indicated in patient with no function impairment (but some physical exam finding consistent of myelopathy)
- patients who are not candidates for surgery
- modalities
- medications (NSAIDS, gabapentin)
- immobilization (hard collar in slight flexion)
- physical therapy for neck strengthening, balance, and gait training
- traction and chiropractic modalities are not likely to benefit and do have some risks
- be sure to watch patients carefully for progression
- outcomes
- improved nonoperative outcomes associated with patients with larger transverse area of the spinal cord (>70mm2)
- some studies have shown improvement with immobilization in patients with very mild symptoms
- indications
- observation, NSAIDs, therapy, and lifestyle modifications
- Operative
- surgical decompression and stabilization
- indications
- functional impairment due to myelopathy
- asymptomatic patients with cord signal changes and radiographic compression is controversial
- outcomes
- prospective studies show improvement in overall pain, function, and neurologic symptoms with operative treatment
- early recognition and treatment prior to spinal cord damage is critical for good clinical outcomes
- indications
- surgical decompression and stabilization