頸椎板切除術後併發上肢肌無力經物理治療介入後之療效-病例報告

Laminectomy is a common surgical approach. However, approximately 5 to 11% of cases encounter postoperative complications of myelopathy in the operated level and suffer muscle weakness in the upper extremity. An imbalance of intraspinal pressure on vertebral body may lead to isthmic spondylolisthesis or intervertebral disk protrusion. Ischemic damage or hematoma in the spinal cannal is another reason that can cause compression to the neurological tissues of the spine. In this case report, we described our approach to treat a 72 year-old male who suffered cervical myelopathy after laminectomy 2 months ago. In the first 2 weeks, electrical muscle stimulation was given to prevent muscle atrophy to his biceps brachialis, but no significant progress had been made. Therefore, we started a cervical stabilization exercise protocol with the aim of improving his head and neck movement control. Mechanical traction and joint mobilization were given to relieve his pain if necessary. After 3 months of therapy, the outcome score rated by the patient with the Global Rating Scale was increased, so were the cervical range of motion and muscle strength of upper extremity. The magnetic resonance image of his cervical spine also showed improvement with decreased displacement of the spondylolisthesis and intervertebral disk protrusion on the operated level.