頸椎神經壓迫症候群病例討論

Cervical Root Compression Syndrome Case Report

一位 42 歲女性項背疼痛已近一年，近因左手指末端指節麻木求診，西醫診斷為頸椎神經壓迫症，給予保守療法未見改善。中醫傷科檢查發現左肩胛骨下垂，第五、六、七頸椎棘突左偏，第五、六頸椎以及第六、七頸椎棘突間距較窄。中醫辨證為痹證，治以整復錯縫，滑利關節，舒筋通絡，活血散瘀。經肩胛骨整復及頸椎整脊整復 12 次，治療一個月後，神經傳導檢查顯示原先的異常已有顯著改善，而左手指節麻木、左肩背及上臂外側疼痛以及頭脹痛等症狀亦均有所改善。本病例之療效顯著，中醫傷科對肩胛骨的正骨整復與脊椎的整脊整復應為關鍵性之因素。

A 42-year-old female who suffered from upper back pain and nuchalgia for nearly a year, requested for medical attention with the chief complaint of left hand numbness. The patient received conservative treatment with western medicine under the impression of cervical radiculopathy, but no significant progress in medical condition was observed after a period of treatment. She therefore turned to Chinese medicine for further management. Palpation performed at Chinese Medicine Traumatology Department revealed inferior displacement of the left scapula, leftward deviation of the tip of 50?? ,6?? and 7?? cervical spinous process, and narrowing of C5/C6 and C6/C7 interspinous space. the patient was subsequently treated with rehabilitative manipulation, joint motion smoothening, soft tissue relaxation, and circulatory promotion techniques, under the impression of 'impediment syndrome' (bizheng). After 12 sessions of scapula and cervical spine manipulation (completed within a month), electrodiagnostic studies demonstrated results consistent with significant progress in reinnervation. Marked relief from pain and numbness was also reported by the patient.