无骨折脱位型颈脊髓损伤患者的治疗与康复

目的探讨无骨折脱位型颈脊髓损伤手术治疗和保守治疗的临床疗效及早期康复效果。方法28例患者分为手术组16例和保守治疗组12例,前者行＂锚定法＂改良单开门颈椎管成型术,并进行早期康复训练,后者入院后即行康复训练。于治疗前、治疗后3个月、6个月、12个月分别对两组患者进行JOA评分,计算改善率。结果两组患者治疗后的JOA评分均较治疗前显著提高（P〈0.001）,但手术组疗效显著优于保守治疗组（P〈0.001）。结论无骨折脱位型颈脊髓损伤患者早期施行减压手术可取得比保守治疗更好的康复效果。

Treatment and Rehabilitation of Patients with Cervical Spinal Cord Injury and without Fracture and Dislocation

Objective To investigate the effect of both conservative and surgical treatment on cervical spinal cord injury without fracture and dislocation.Methods28 patients were divided into the surgical group (16 cases, treated with modified open door laminoplasty using anchor method and carried on early rehabilitation training) and conservative group (12 cases, treated with rehabilitation training after admission). All patients were assessed with JOA grade before and 3 months, 6 months and 12 months after treatment, and improvement rate was calculated.ResultsJOA grade of all patients increased after both surgical and conservative treatment ( P< 0.001), but the effect of surgical treatment was significant better than that of conservative treatment ( P< 0.001).ConclusionThe effect of early surgical treatment on cervical spinal cord injury without fracture and dislocation is superior to conservative treatment.