中央型颈脊髓损伤保守与手术治疗的对比研究

目的对比研究手术与非手术治疗中央型颈脊髓损伤的临床疗效。方法中央型颈脊髓损伤患者120例,手术治疗72例,其中前路手术28例,后路手术44例;非手术治疗48例。详细记录患者ASIA运动功能评分(AMS),对治疗前及治疗后6个月、2年时的AMS评分进行比较。结果96例获随访,时间6个月~5年,21例失访,3例死亡。两组治疗后6个月、2年时AMS评分之间差异有显著性(P<0.05)。治疗后6个月内非手术组6例出现并发症(6/48,12.5%),手术组4例出现并发症(4/72,5.6%),两组之间差异无显著性(P>0.05)。结论手术治疗中央型颈脊髓损伤疗效可靠。早期手术能够解除脊髓压迫,稳定颈椎,促进脊髓功能恢复。

Comparison of effect on cervical central cord injury with conservative and surgical treatments

Objective To compare the effect on cervical central cord injury with conservative and surgical treatments.Methods 120 cases of cervical central cord injuries were treated in our hospital.All were incisively checked and recorded with American Spinal Injury Association motor score.72 cases were treated by anterior or posterior operation,while others were treated conservatively.Results 96 patients were followed for 6 months~5 years,while 21 were lost during follow-up,and 3 died.The AMS of the two groups were significantly different,which recorded by the 6 months and 2 years after treatment(P<0.05).The complication rate of the two groups were no significantly different(P>0.05).Conclusions It is easy and effective to treat cervical central cord injury by surgery.Early operation can resolve compression of the spinal cord,stabilize cervical spine,and promote the recovery of injured spinal cord.