外伤性急性颈椎间盘突出症(附19例报告)

本文旨在阐明MRI对急性颈椎间盘突出的诊断价值。19例均有明显的外伤史,X线片无骨折脱位者12例。其中C_(5～6),髓核突出7例,C_(5～6)、C_(1～5),突出5例。有小关节绞锁半脱位者7例,MRI均示损伤间隙有髓核突出。19例均为不全瘫。全部病例经前路椎间盘切除、植骨融合。平均随访15个月,植骨块平均于12周愈合。除1例骨块退出4～5mm外,余位置良好。脊髓功能均有明显恢复。结论:外伤是急性颈椎间盘突出的主要原因,而颈椎间盘突出又是SCIWORA综合征的主要原因。对小关节绞锁半脱位者应考虑同时有椎间盘突出的可能。手术治疗一般效果良好。

Traumatic Acute Cervical Disc Prolapse with Nineteen Cases Report

This article evalute the value of MRI in the diagnosis of acute cervical disc proapse. All the 19 cases were associated with the factor of injury. Twelve cases were spinal cord injury without radiographic abnormality, and the other 7 cases showed locked facets with X-ray plate. In the 12 cases MRI showed dise herniation between C5 and C6 in 7cases, and herniation in both C4-5 and C5-6] space in 5 cases. In other 7 cases with locked facets MRI showed herniation of discs in the injuried space . All the 19 cases were complicated with incomplete neurologic deficit, and after the operation of discectomy and interbody fusion. All the graft bone healed in average time of 12 weeks ,and the function of the spinal cord improved obviously. Within the average following-up time of 15 month-s. Only one graft bone protruded anteriorly for about 4-5mm. Conclusion: Acute cervical disc prolapse were mainly due to injury. And cervical herniation was the main cause of SCIWORA Syndrome. The possibility of acute cervical disc herniation should be considered in the cervical spine of locked facets and operation could always get good results .