椎动脉型颈椎病影像改变对康复治疗的指导意义.pdfVIP

中华物理医学与康复杂志2004年7月第26卷第7期 Chin J Phys Med Rehabil，July 2004，Vo1．26，No．7 · 4l5· ． 临 床 研 究 ． 椎动脉型颈椎病影像改变对康复治疗 的指导意义 代成甫 段贤斌 杨大志 钱立 【摘 要】 目的 研究椎动脉型颈椎病的x线表现特征，以及对康复治疗的指导意义。方法 对42例 椎动脉型颈椎病患者的x线片进行测量分析，分别采用颈部制动、牵引、高位硬膜外封闭及手术疗法，同时配 合扩管治疗，观察不同治疗方法对各种l临床症状的治疗效果。结果 椎动脉型颈椎病患者x线片显示颈椎生 理曲度变直、颈椎不稳、钩椎关节增生。颈部制动可有效改善头晕、恶心、视物模糊等症状，适用于x线示颈 椎生理曲度改变不明显，无成角或位移病例；牵引治疗对头痛、颈肩痛、四肢乏力等症状改变明显，适用于x 线示颈椎生理曲度改变明显，有成角或位移病例；高位硬膜外封闭近期效果好，适用于对上述治疗疗效不佳或 椎体移位、成角较严重的急性发作期患者，尤其对胸闷、耳呜、多汗、睡眠差有显著效果。结论 颈椎x线片改 变在椎动脉型颈椎病的诊断及治疗中具有重要参考意义。 【关键词】 颈椎病；椎动脉；X片；康复治疗 The significance of X·ray imaging in rehabilitati0n treatment of cervical spondylosis of vertebral artery type DAI Cheng-fu，DUAN Xian—bin，YANG Da—zhi，QIAN Li．Department of Orthopedics，the Shenzhen People§ Hospital，the MedicaZ SchooZ of Jinan University，Shenzhen 5 1 8020，China 【Abstract】0bjective To characterize the x—ray image of vertebral artery type of cervical spondylosis and explore its significance in rehabilitation treatment． Methods The X—ray films of 42 cases of vertebral artery type of cervical spondylosis were measured and analyzed．The treatment approaches including restriction of cervical move— ment，traction，epidural block and surgery were planned and implemented accordingly． Results The X—ray image revealed the following changes in the patients：the straightened physiologic curvature of the cervical spine，cervical vertebral unsteadiness，zygapophyzeal joint hyperplasia．Various treatment approaches are effective to patients with various manifestations． Conclusion Employing treatment approaches on the basis of X—ray images is of great signi— icance for the effective treatment of patients with cervical spondylosis of vertebral artery type．f 【Key words】 Cervical spondylosis； Vertebral artery type；X—ray image； Rehabilitation treatment 椎动脉型颈椎病是一种常见病，临床