推拿致急性颈脊髓损伤21例

目的 探讨颈肩痛行推拿或按摩治疗引起急性颈髓损伤的原因及防治措施。方法 回顾性分析２１例按摩致急性脊髓损伤患者的临床特点及Ｘ线资料，测量每例Ｃ３￣Ｃ７椎体矢状径和椎管矢状径并求其比值。２１例患者均于损伤后早期行后路椎管扩大成形术并植骨融合稳定脊椎。结果 ２１例患者按摩或推拿前有发育性椎管狭窄１５例，占７１．４％；有６例存在退变性狭窄，占２８．６％。所有患者经手术治疗均获满意效果。结论 医务人员对此

Acute Cervical Spinal Cord Injury Caused by Manipulation

Objective To study the etiology, prevention and treatment of acute cervical spinal cord injury induced by manipulation and massage. Methods Twenty-one cases of acute cervical spinal cord injury caused by manual treatment were reviewed. Sagittal diameters of the spinal canals and vertebral bodies (C3-C7) were measured in every patient, and the ratios were calculated. All patients underwent surgical operations. Results Of the 21 cases, 15 (71.4%) belonged to developmental stenosis of the spinal canals and 6 retrograde stenosis before manipulation. Conclusions Hyperextentionally and hyperflexionally lateral roentgenograms of the cervical vertebrae should be taken as a routine before manual treatment. More attention should be paid to the sagittal diameters of the spinal canal and stability of the intervertebral joints simultaneously. Regional instability of intervertebral joints should be regarded as contraindication for manipulation. Surgical decompression and enlargement of the spinal canal at early stage after spinal cord injury is helpful to the patients.