方法:文献综述。
目的:脊髓病变可继发于几种病因,表现和治疗相似。因此,这方面有很多不确定因素,包括最佳术语和定义。最近的合作颈椎研究导致了这个名字的提议和随后的社区采用退行性颈椎病(DCM),这促进了DCM国际商定的研究重点的建立。我们提出了引入术语退行性胸脊髓病(DTM)和退行性脊髓脊髓病(DSM)作为DCM和DTM的总称的案例。
方法:遵循PRISMA指南,我们进行了系统的文献检索,以确定Embase和MEDLINE中的退行性胸脊髓病文献.
结果:包含在DTM中的条件包括胸椎脊髓病,后纵韧带骨化,黄韧带骨化,韧带钙化,韧带肥大,椎间盘退行性疾病,胸椎骨关节炎,椎间盘突出,和后部骨赘。经典的演讲包括腰带疼痛,步态紊乱,腿无力,感觉障碍,膀胱或肠功能障碍,经常伴有背痛。手术治疗通常有利于术后结果,取决于许多因素。包括致病病理学,和其他狭窄的存在。
结论:术语DTM涵盖的临床实体是相互关联的,可以同时显示,和呈现类似。在颈椎中一致采用DCM和最近提出的退行性神经根病(DCR)的基础上,将这个共同的命名框架扩展到退行性脊髓病和退行性胸脊髓病这两个术语将有助于提高识别和交流。
METHODS: Literature
Review.
OBJECTIVE: Myelopathy affecting the
thoracic spinal cord can arise secondary to several aetiologies which have similar presentation and management. Consequently, there are many uncertainties in this area, including optimal terminology and definitions. Recent collaborative cervical spinal research has led to the proposal and subsequent community adoption of the name degenerative cervical myelopathy(DCM), which has facilitated the establishment of internationally-agreed research priorities for DCM. We put forward the case for the introduction of the term degenerative thoracic myelopathy(DTM) and degenerative spinal myelopathy(DSM) as an umbrella term for both DCM and DTM.
METHODS: Following PRISMA guidelines, a systematic literature search was performed to identify degenerative
thoracic myelopathy literature in Embase and MEDLINE.
RESULTS: Conditions encompassed within DTM include
thoracic spondylotic myelopathy, ossification of the posterior longitudinal ligament, ossification of the ligamentum flavum, calcification of ligaments, hypertrophy of ligaments, degenerative disc disease,
thoracic osteoarthritis, intervertebral disc herniation, and posterior osteophytosis. The classic presentation includes girdle pain, gait disturbance, leg weakness, sensory disturbance, and bladder or bowel dysfunction, often with associated back pain. Surgical management is typically favoured with post-surgical outcomes dependent on many factors, including the causative pathology, and presence of additional stenosis.
CONCLUSIONS: The clinical entities encompassed by the term DTM are interrelated, can manifest concurrently, and present similarly. Building on the consensus adoption of DCM in the cervical spine and the recent proposal of degenerative cervical radiculopathy(DCR), extending this common nomenclature framework to the terms degenerative spinal myelopathy and degenerative thoracic myelopathy will help improve recognition and communication.