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急性创伤性无骨折脱位型颈髓损伤的临床研究
引用本文:沈宁江,林庆彪,陈建,林明侠.急性创伤性无骨折脱位型颈髓损伤的临床研究[J].实用骨科杂志,2004,10(4):312-314.
作者姓名:沈宁江  林庆彪  陈建  林明侠
作者单位:海南省人民医院,海南,海口,570311
摘    要:目的 探讨急性创伤性无骨折脱位型颈脊髓损伤的机制及治疗方法。方法  75例患者行常规 X线摄片、CT扫描及 MRI检查。结果 常规 X线摄片及 CT扫描均不能确切了解颈脊髓损伤的病因及机理。根据 MRI检查分为两种类型 ,a)颈椎间盘突出颈脊髓损伤型 ,本组 6 2例。4 9例脊髓受压明显者予以手术治疗 ,13例脊髓受压较轻者予以非手术治疗。b)无颈椎间盘突出颈脊髓损伤型 ,13例均予以非手术治疗。随访 6 7例 ,随访时间 1~ 10 a,平均 4 a,除2例 Frankel A级、1例 Frankel B级无恢复外 ,其余患者神经功能均有不同程度恢复。结论 无骨折脱位型颈脊髓损伤应尽早行 MRI检查 ,以明确临床类型。对颈脊髓受压明显的颈椎间盘突出者 ,应尽早手术治疗 ,对无颈椎间盘突出者采用大剂量甲基强的松龙等非手术治疗 ,亦具有较好的疗效。

关 键 词:颈椎  脊髓损伤  颈椎间盘
文章编号:1008-5572(2004)04-0312-03
修稿时间:2004年2月18日

Clinical Analyses of Acute Traumatic Cervical Spinal Cord Injury without Radiographic Fracture/Dislocation
SHEN Ning-jiang,LIN Qing-biao,CHEN Jian,LIN Ming-xia.Clinical Analyses of Acute Traumatic Cervical Spinal Cord Injury without Radiographic Fracture/Dislocation[J].Journal of Practical Orthopedics,2004,10(4):312-314.
Authors:SHEN Ning-jiang  LIN Qing-biao  CHEN Jian  LIN Ming-xia
Abstract:Objective To investigate the mechanism and treatment of acute traumatic cervical spinal cord injury without radiographic abnormality. Methods The conventional radiography,CT and MRI were performed in 75 cases. Results The conventional radiography and CT scan could not reveal the true reasons of the spinal cord injury(SCI). According to MRI examination,two mainly types were divided. a) SCI with cervical disc herniation. There were 62 cases. 49 cases with SCI by serious compression were operated. 13 cases w ith SCI by slight compression were treated non-operatively. b) SCI without cervical disc herniation. There were 13 cases,who were carried out non-operative treatment. 67 cases were followed-up 1 year to 10 years with average of 4 years. Among them,2 cases with Frankel A and 1 case with Frankel B level paraplegia were not relieved. Others recovered in varied degrees. Conclusion Early MRI examination should be used to judge the injury type. The patients with cervical disc herniation and obvious spinal cord compression should be operated early. But for the patients without cervical disc herniation,high dose methylprednisolone and other non-operative treatment can promote neurologic recovery.
Keywords:cervical spine  spinal cord injury  cervical disc
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