方法:一项前瞻性观察性研究。
目的:了解退行性脊髓型颈椎病(DCM)患者术前神经源性肠功能障碍和神经源性膀胱的发生率,探讨颈椎减压术后症状改善的程度和时机。还分析了促进症状改善的因素。
方法:在75例DCM患者中,便秘评分系统(CSS)评分,国际前列腺症状评分(IPSS)和日本骨科协会(JOA)评分在手术前和术后1,3,6和12个月进行评估.计算患病率。有关患者年龄的数据,性别,疾病状态,疾病持续时间,病变水平,并前瞻性记录和分析评分变化.
结果:术前排便和排尿功能障碍的患病率分别为41.3%和34.7%,分别。排便功能障碍患者中,术后1,3,6和12个月好转的患者数分别为10,9,9和6.在排尿功能障碍患者中,相应的患者数分别为12,10,11和11.我们检查的因素都没有与CSS或IPSS评分的改善显着相关;但是,下肢JOA评分的改善往往与两者的改善相关。
结论:DCM患者排便症状和排尿功能障碍的患病率分别为41.3%和34.7%,分别。减压手术改良了20%~46%的患者症状。
METHODS: A prospective observational study.
OBJECTIVE: To investigate preoperative prevalence of neurogenic bowel dysfunction and neurogenic bladder in patients with degenerative cervical myelopathy (DCM) and examine the degree and timing of symptom improvement after cervical decompression surgery. Factors contributing to symptom improvement were also analyzed.
METHODS: Among 75 patients with DCM who underwent cervical decompression, Constipation Scoring System (CSS) score, International Prostate Symptoms Score (IPSS), and Japanese Orthopaedic Association (JOA) score were assessed before surgery and 1, 3, 6, and 12 months after. Prevalence rates were calculated. Data regarding patient age, sex, disease status, disease duration, lesion level, and score changes was prospectively recorded and analyzed.
RESULTS: The prevalence rates of defecation and urinary dysfunction before surgery were 41.3% and 34.7%, respectively. Among the patients with defecation dysfunction, the number of patients who improved 1, 3, 6, and 12 months after surgery was 10, 9, 9, and 6, respectively. Among the patients with urinary dysfunction, the corresponding number of patients was 12, 10, 11, and 11, respectively. None of the factors we examined were significantly associated with improvement in either CSS or IPSS score; however, improvement of lower extremity JOA score tended to be associated with improvement in both.
CONCLUSIONS: The prevalence of symptoms of defecation and urinary dysfunction in patients with DCM was 41.3% and 34.7%, respectively. Decompression surgery improved symptoms in 20% to 46% of patients.