无骨折脱位型颈脊髓损伤的手术治疗及疗效观察

目的探讨无骨折脱位型颈脊髓损伤的手术治疗及效果。方法回顾分析深圳市光明新区光明医院2003年10月至2008年6月收治28例无骨折脱位型颈脊髓损伤患者,依据影像学表现、致伤特点及病理基础采用3种手术方式:颈前路椎间盘摘除减压cage植入钢板内固定术7例。全椎板切除减压颈椎后路钉棒系统内固定辅以侧块间植骨融合术12例。颈前路椎体次全切除减压钛网植入钢板内固定术9例,术后根据不同情况进行对症及康复治疗。结果所有病例术中均未发生血管、神经损伤等并发症,28例均得到随访,随访时间6～38个月(平均18.5个月)。术后按Frankel分级标准及计算JOA改善率进行评定。其中1例A级患者术后到C级;16例B级患者,术后4例达C级,10例达D级,2例达E级;9例C级患者,术后4例达D级,5例达E级;2例D级患者,1例达E级,1例稍改善。术后JOA评分较术前平均增加7.34分,术后JOA评分改善率为68.9%。结论无骨折脱位型急性颈脊髓损伤应早期手术治疗,根据病理基础及受伤机理采取合理手术方式,可以获得良好的临床疗效。

Clinical Efficacy and Surgical Treatment about Without Fracture and Dislocation of the Cervical Spinal Cord Injury Patients

Objective To investigate the surgical treatment and effect about non-fracture and dislocation of the cervical spinal cord injury patients. Methods Retrospective analysis of Guangming new district hospital in October 2003-2008 year in June without fracture and dislocation treated 28 cases of cervical spinal cord injury patients,based on imaging performance,injury characteristics and the pathological basis of using three kinds of operation methods:anterior cervical disc between cone cage implant removal decom...