摘要目的 分析总结第7颈椎与第1胸椎(C_7～T_1)椎间盘突出症的临床特点及后路手术的疗效.方法 回顾性分析2000年8月至2008年8月间手术治疗的12例C_7～T_1椎间盘突出症,观察分析其独特的临床表现、影像学特点及术中所见,观测比较手术前后患侧手的肌力情况.结果 12例C_7～T_1椎间盘突出症均为侧方型,均表现有患侧手内肌萎缩、肌力下降,9例无感觉异常.接受椎板开窗或钥匙孔减压突出椎间盘摘除手术,经过平均26个月(6～39个月)的随访,术后并指肌力平均改善16%,屈指肌力平均改善26%,伸指肌力平均改善32%.结论 C_7～T_1椎间盘突出症以侧方型为主,侧方突出的椎间盘大多数只压迫颈8神经根之前根,患者都有不同程度的患侧手内肌萎缩,手内肌无力,只有少数患者合并有感觉障碍.后路突出椎间盘摘除治疗侧方型C_7～T_1椎间盘突出症安全有效.

abstractsObjective To study the outcome of laminoforaminotomy with posterolateral discectomy for patients with lateral disc herniation at C_7-T_1.Methods From August 2000 to August 2008,12 patients with lateral disc hemiation at C_7-T_1 underwent posterolateral discectomy were analyzed retrospectively.Neurologic function were elvahlated with the Motor Scoring System Preoperative motor were compared with postoperative one.The unique clinical manifestation,imageology features and intraoperative findings were analyzed.Results All these twelve patients were lateral type.All the patients showed hand intrinsic muscles atrophy and hand weaknese.Nine patients had no paraesthesia.The average follow-up period was 26 months.Postoperative scores were significantly higher than preoperative ones.Conclusions Dise hemiation at C_7-T_1 is predominantly lateral type and present C_8 nerve motor deficit(hand intrinsic muscles atrophy and hand weakness) and only minority has paraesthesia in C_8 nerve dermatome.Poslerolateral cervical discectomy technique is safe and effective for patients with lateral disc herniation at G7-T1.