急性无骨折脱位型颈髓损伤诊治分析

目的:探讨急性无骨折脱位型颈髓损伤的形成因素、诊断及治疗方法。方法:对26例无骨折脱位型颈髓损伤患者的临床诊治资料进行回顾性分析,随访观察近期疗效。结果:26例无骨折脱位型颈髓损伤患者中,退变性椎管狭窄11例(42.3%),单一节段颈椎间盘突出7例(26.9%)。本组病例平均随访14.3个月,3例轻度脊髓损伤患者保守治疗完全恢复,手术患者术前JOA评分平均为4.2分,术后1月平均为11.5分,最后随访平均为13.5分,术后改善率为72.7%。前路手术固定节段均获骨性融合;后路手术术后MRI检查显示椎管容积扩大,颈髓受压缓解。结论:颈椎椎管狭窄是无骨折脱位型颈髓损伤的重要病理基础;合理选择术式,手术操作正确,前、后路手术均能获得较理想的脊髓功能恢复效果。

Analysis on Diagnosis and Treatment of Acute Cervical Spinal Cord Injury without Facture and Dislocation

Objective: To study the cause、diagnosis and therapy of cervical spinal cord injury without fracture and dislocation.Methods: A retrospective study was performed on 20cases of acute cervical spinal cord injury without fracture and dislocation and short-term outcomes were evaluated upon different therapies that were performed accordingly.Results: Of all,eleven(42.3%) were with degenerative cervical canal stenosis,7 with single-level cervical disc protusion.All cases were followed up for average 14.3months.3 patients with partial paralysis recovered completely.Of the operative group,The preoperative average JOA scale score was 4.2 points,The postoperative average JOA scale score after one month was 11.5points and last follow up was 13.5 points.The recorvery rate was 72.7%.Conclusion: Cervical canal stenosis might be the main pathological basis of the cervical spinal cord injury without fracture or dislocation.If operative method is proper and operative process accurate,either anterior or posterior app roach could achieve good myeloid functional recovery.