Cervical Spondylotic Myeloradiculopathy 환자에 대한 임상적 고찰 = Clinical Assessment on Patients with Cervical Spondylotic Myeloradicuopathy

국문 초록 (Abstract)

Cervical spondylotic myeloradiculopathy의 임상증상 및 소견을 나타내어 입원 가료를 받았던 102명의 환자를 대상으로 시행한 보존적 및 수술적 가료에 대한 임상적인 결과를 확인하였으며 아울러 여러 임상적인 요인들이 치료 결과 및 예후에 미치는 상관관계 유무를 분석하였다.
가장 흔한 임상적 유형은 myeloradiculopathy로 57.8%의 환자에서 관찰되었으며 평균 연령은 52세였고 남녀비는 약 3 : 1 정도였다.
다발성 부위 병소는 52%의 환자에서 관찰되었고 C_(5-6) 부위가 가장 많이 침범되었다. 가장 심한 병소부위에서의 경추관 전후 직경은 10.2±1.64mm로 정상 대조군에 비하여 현저한 협소를 나타내었다(p<0.01).
전반적인 치료 결과는 보존적 치료를 받은 환자 중 65.3%가 수술적 치료를 받은 환자 중 86.8%가 치료 전과 비교하여 호전되었다.
여러 임상적 요인들(연령, 증상의 심한 정도, 다발성 병소 침범 유무, 증상의 지속기간 및 수술방법) 중에서 증상의 심한 정도만이 치료 결과 및 예후와 통계적으로 유의한 상관관계를 보였다.
수술의 합병증은 3례에서 경미한 신경장애를 보였으나 호전되었고 1례에서 자가 이식된 골편의 이탈이 있었다.

다국어 초록 (Multilingual Abstract)

Cervical spondylosis is known to be one of the most common disorders involving bony and neural structures of cervical region and shows variety of clinical menifestations namely radiculopathy. myelopathy, or both. Also, the outcome of the treatment of this disorder, whether surgical or nonsurgid shows wide variations accordrng to h a n W reports from different institutions. The purpose of this report is to assess the patients treated by our department for their spondybgenic symptoms.
The results of treatments from 102 patients with cervical spondylotic radiculopathy and/or myelopathy were clinically assessed Among them, thuty eight patients were undelwent operation and followed up for at least six to twelve month period- Remaining sixty four patients wexe treated conservatively for three weeks to three months.
The results are as follows:
1) Among 102 patients the most common type was combined myeloradiculopathy(57.8%).
2) Mean age was 52 years with range between 31 to 74 years. Male to female ratio was about three to one.
3) Multiple level involvement was 52% and C5-6 was the most commonly involved level by srngle lesions.
4) Mean Ap diameter of c e M d canal of the spondylotic patients as compared with the control group, was signiEcantIy narrowed(p<O.OI).
5 ) Overall outcome by conservative treatment showed 65.3 % improvement and 86.8 % improve ment by operative treatment.
6 ) Among various clinical factors studied(age, severity. duration of symptoms multiple level involvement methods of operation). only the degree of severity revealed statistidy signiticant effect on outcome of both conservative and operative group.
7) There were three cases of mild transient neurological complications and one case of technical complication(graft extrusion).