| 赵柏森.颈椎后路术后轴性症状的临床研究进展[J].浙江中西医结合杂志,2026,36(5): |
| 颈椎后路术后轴性症状的临床研究进展 |
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| 投稿时间：2025-09-27 修订日期：2026-02-05 |
| DOI： |
| 中文关键词: 颈椎后路手术 轴性症状 危险因素 椎板成形术 Modic改变 颈后肌群-韧带复合体 治疗 |
| 英文关键词:Posterior Cervical Spine Surgery Axial Symptoms Risk Factors Laminoplasty Modic Changes Posterior Cervical Muscle Group-Ligament Complex treatment |
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| 中文摘要: |
| 颈椎后路手术是治疗脊髓型颈椎病、颈椎椎管狭窄等疾病的重要术式，但术后轴性症状（Axial Symptoms, AS）的高发率严重影响着患者术后的生活质量。目前针对AS的治疗主要包括中西医结合方式，如中药内服与外敷、针灸、康复锻炼及西药干预等，以缓解疼痛、改善功能，本文系统回顾国内外相关研究，从术前、术中、术后三方面分析AS的危险因素及目前中西医防治策略。术前因素包括年龄、性别、吸烟史等基线特征及术前颈肩疼痛及影像学异常（如Modic改变、椎管侵占率）；术中风险集中于颈椎生物力学失衡、小关节损伤及颈后肌群-韧带复合体（SPLMC）破坏；术后管理强调缩短颈托佩戴时间（≤2周）及早期功能锻炼。未来应不断完善颈椎后路术后AS的相关防治策略，降低AS的发生率，提升患者生活质量，进一步优化临床管理。 |
| 英文摘要: |
| Posterior cervical surgery serves as a critical approach for treating cervical spondylotic myelopathy and cervical spinal stenosis. However, the high incidence of postoperative axial symptoms (AS) significantly impacts the quality of life of patients. Current treatments for AS include integrated Chinese and Western approaches such as herbal medicine, acupuncture, rehabilitation training, and pharmaceutical interventions to alleviate pain and improve functionality. This paper systematically reviews domestic and international studies, analyzing risk factors and prevention strategies for AS from preoperative, intraoperative, and postoperative perspectives. Preoperative risk factorsinclude advanced age, smoking history, preoperative neck-shoulder pain, and imaging abnormalities (such as Modic changes, spinal canal occupancy rate).Intraoperative risksprimarily involve cervical biomechanical imbalance, facet joint injuries, and damage to the posterior cervical muscle-ligament complex (SPLMC).Postoperative managementemphasizes reducing cervical collar immobilization time (≤2 weeks) and implementing early functional rehabilitation. Future efforts should focus on continuously refining prevention and management strategies for axial symptoms (AS) following posterior cervical surgery to further optimize clinical outcomes. |
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