成人颈椎无骨折脱位型脊髓损伤32例疗效分析

目的总结并分析对32例无骨折脱位型脊髓损伤患者的治疗,探讨其发病机制、特点及疗效。方法对2006年6月~2009年7月32例无骨折脱位型脊髓损伤患者分别进行围领制动、枕颌带牵引、颅骨牵引等保守治疗14例,采用前路减压融合固定、后路椎管扩大成形的手术治疗18例,随访6~18个月,观察其疗效。结果应用JOA17评分法进行评价,本组病例治疗前JOA评分:0~12分,平均5.2分,末次随访JOA评分:0~17分,平均11.5分,改善率为53.4%。结论成人颈椎无骨折脱位型脊髓损伤,根据患者的不同特点、有针对性地选择治疗方法和术式,可以获得较好的临床疗效。

Efficacy Analysis on 32 Cases of Spinal Injury without Fracture and Dislocation of Cervical Vertebrae in Adults

Objective To summarize and analyze the treatment of the patients with spinal cord injury without fracture and dislocation and explore its mechanism, characters and efficacy. Methods Of 32 eases of spinal cord injury without fracture and dislocation enrolled from June 2006 to July 2009,14 eases in conservative treatment were treated with neck brake, manidulo - occipital bandage traction and skull traction and 18 eases in operative treatment were treated with anterior decompression and fusion with fixation, and posterior laminoplasty. After follow - up for 6 to 18 months,the efficacy was observed. Results JOA17 scale was adopted ,in which JOA score before treatment：0 - 12 scores,5.2 scores in average;JOA score in the last follow - up ：0 - 17scores, 11.5 scores in average. The rate of improvement was 53.4%. Conclusion A quite good clinical efficacy can be obtained on spinal cord injury without fracture and dislocation of cervical vertebrae in adults according to the individual character, specific selective treatment program and operative method.