颈椎病与急性颈脊髓损伤

从1980年10月到1994年1月我们收治41例无颈椎骨折脱位的急性颈脊髓损伤,同时在X线、CT及MRI皆有颈椎病的改变.分两组治疗方法比较,手术组皆在颅骨牵引下进行颈椎前路减压、钩椎关节增生部刮除、取自体髂骨或异体骨作椎间植骨融合术.非手术组行颅骨牵引、脱水、皮质激素、神经营养药物、中药及激光血疗,以及早期康复脊髓功能.随访1～9年4个月,平均5年1个月.手术组优14例、显效4例、差3例.非手术组优5例、显效7例、差8例.治愈显效率:前者为85.5%,后者为60%.手术组优于非手术组,P<0.05,有显著意义.治愈显效者皆在不同时间内恢复原来工作,无任何并发症.治疗的关键是选择适当的病例及严格的手术指征,熟练手术方法的技巧及术前术后的精心护理.本文对发病机理、诊治及命名亦进行了初步探讨.

Cervical Spondylosis and Acute Spinal Cord Injury

Forty-one cases of acute cervical spinal cord injury which have not fracture -dislocation,but they have been proved as cervical spondylosis by X-ray ,CT and MRI. Twenty-one cases were cured with anterior approach decompression. The degenerative Luschas' joint and osteophytes were also removed and bone graft fusion in cervical intervertebral. Twenty cases were delt with conservative treatment. Follow up study carried out for 1 to 9 years and 4 months; surgical group excellent 14 cases,good 4 cases,poor 3 cases,excellent and good: 85. 5%,non -surgical group:excellent 5 cases,good 7 cases,poor 7cases,excellent and good;60%.Results of surgical group were better than non -surgical (P<0. 05). In 18 cases,there were no postoperative complication and all returned to their occupations satisfactorily. This shows that operaion is an effective method in curing cervical spondylosis and acute spinal cord injury,but the conditions of indication,technique and nuring should be requested strictly.